早期持续肠内营养对食管癌术后患者预后的影响

目的 探讨食管癌术后早期持续肠内营养支持对患者预后的影响.方法 将248例食管胃底贲门癌根治手术的患者随机分为肠内营养(EN)组和肠外营养(PN)组各124例,手术后第1天开始分别给予营养支持6 d,于术前1 d、术后8 d检测体质量、血常规、肝功能,并观察并发症的发生率.结果 EN组体质量、红细胞数、血红蛋白、白蛋白等下降幅度少于PN组(P＜0.01).EN组患者术后无吻合口瘘发生,肺部感染发生率为13.8%,胸液量平均为780 ml,无切口愈合不良者;PN组患者吻合口瘘发生率3.2%,肺部感染发生率28.2%,胸液量平均为1 842 ml,切口愈合不良发生率7.2%.结论 术后早期EN比PN对食管癌营养状况的改善更好,并发症发生率更低.

Effects of early enteral nutrition on prognosis of patients with sustained esophageal caner

Objective To investigate the effect of early enteral nutrition.Methods 248 patients with esophageal and gastric carcinoma were randomly divided into two groups,and received enteral nutrition(EN)and parenteral nutrition(PN)each continuously for 6 days after operation.The body weight,blood routine test,liver function,and postoperative day 8 were compared with those before operation.Results The body weight,red blood cell count,and the levels of hemoglobin,serum albumin and transaminase decreased less in EN group than those in PN group(P＜0.01).The complication rates of anastomotic fistula,pulmonary infection,and delayedincision healing and average volume of pleural effusion were 0,13.8%,0,780ml in EN groups,while 3.2%,28.2%,7.2%,1842ml in PN group.Conclusion Early postoperative enteral nutirtion after esophageal carcinoma surgery can improve nutritional status and reduce complications in comparision with parenteral nutrition.