食管癌术后早期肠内营养预防肺部感染的临床研究

目的研究食管癌术后早期肠内营养对预防肺部感染所起的作用.方法把食管贲门癌剖胸切除术患者随机分为治疗组(EN)和对照组(PN).EN组(n=50)采用术后第1～5天经鼻肠营养管滴饲能全力500～1 000ml/d,PN组(n=45)术后仅予静脉营养支持;两组病例均在术后第1天和第5天查血淋巴细胞计数、白蛋白、转铁蛋白、前白蛋白,观察这5 d内有否肺部感染.结果EN组术后无肺部感染病例,PN组4例;EN组术后第1天和第5天的白蛋白和淋巴细胞计数前后对比升高明显(P＜0.01),而PN组稍有升高(P＞0.05);两组患者的转铁蛋白和前白蛋白前后对比轻微升高(P＞0.05).结论食管癌术后早期肠内营养有预防肺部感染作用.

Early Stage Enteral Nutrition for Preventing Postoperative Pulmonary Infection in Patients with Esophageal Carcinoma : A Clinical Research

OBJECTIVE To study the role of early stage enteral nutrition(EN) for preventing postoperative pulmonary infection in patients with esophageal carcinoma. METHODS Patients with esophageal or cardial carcinoma were divided into EN group(n=50) and parenteral nutrition(PN) group(n=45).Nutrison Multifibre was administered for EN group(500-1 000ml/d,d1-d5 after operation,via a nasointestinal tube),and the PN group was supported only by intravenous nutrition.The lymphocyte,albumin,prealbumin and transferrin were detected on d1 and d5,and the occurrence of pulmonary infection was observed. RESULTS There was no pulmonary infection in EN group,while there was(4 cases with pulmonary) infections in PN group.Compared with preoperative items,lymphocyte and albumin increased significantly on d1 and d5 in EN group(P<0.01),and there was a slight increase in PN group(P>0.05).Prealbumin and transferrin just slightly increased after operation in both groups(P>0.05). CONCLUSIONS Early stage EN could play a role for preventing postoperative pulmonary infection in patients with esophageal carcinoma.