食管、贲门癌术后早期肠内营养的应用研究

目的 :探讨食管、贲门癌术后早期肠内营养支持的方法、效果、费用及应用中的注意事项、并与肠外营养比较。方法 :选择食管、贲门癌病人 75例按序随机分成肠内营养 (EN ,n=30 )、肠外营养 (PN ,n =2 3)及普通输液组 (对照组 ,n =2 2 ) ,营养支持时间为 8天 ,分别测定术前、术后第 8天营养指标 ,记录肛门排气时间、不良反应及手术并发症、住院时间及治疗费用。结果 :三组血浆总蛋白、白蛋白、转铁蛋白均较术前下降 ,以对照组为显。前白蛋白PN、EN组有显著升高 (P <0 0 1)。三组体重皆下降 ,以对照组为显 (P <0 0 1)。术后肠道功能恢复以EN组最快。术后并发症发生率以对照组为高。住院时间以对照组最长。治疗费用PN明显高于EN。结论 :食管、贲门癌术后早期肠内营养安全可行 ,临床疗效与PN相似 ,且比PN有更好的代谢效应 ,在保护肠粘膜屏障、促进肠功能恢复、减少住院费用等方面也更为优越

The Use of Early Enteral Nutrition in Post-operative Patient with Esophageal or Cardiac Cancer

Objective:To investigate the efficacy,cost and precautions in the treatment of esophageal and Cardiac carcinomas?with early postoperative enteral nutrition in comparison with to parenteral nutrition.Methods:Seventy-five cases of esophageal or cardiac cancer were randomly divided into EN group(n=30),PN group(n=23)and routine supplement group(n=22).The time for nutritional support were 8 days.The nutritional status of patients were measured before and after nutritional support.The complications,vital signs and recovery of gastrointestinal function were carefully observed.The time in hospital and the cost of each case were recorded.Results:The level of serum total protein,albumin,transferring ferroprotein and weight in the three groups were declined after operation( P <0 01).It was more obvious in the control group.The level of prealbumin was obviously elevated in PN and EN groups.The bowel moved obviously earlier in EN group than the other two groups and the rate of morbidity was the lowest after operation.Time in hospital was shortest and the cost was low in EN group.Conclusions:Early EN for post-operative patients with esophageal cancer and cardiac cancer was safe and feasible.EN was similar to PN in curative effect,but EN was superior terms of recovery of gastrointestinal function and more cost effective.