CAJ | 학술논문

目的探讨早期肠内营养支持对食管癌术后小肠运动功能的影响.方法前瞻性入组2011年6-7月间北京大学肿瘤医院胸外一科单一手术组收治的35例食管癌手术患者,按随机数字表法随机分为早期肠内营养组(20例)和早期静脉营养组(15例).术前进行营养风险筛查,术后24 h内对其分别给予整蛋白制剂的肠内营养和肠外营养支持,监测患者肠鸣音恢复的时间及胃肠道症状.结果肠内营养组和静脉营养组术后肠蠕动恢复时间分别为(45.1±20.3)h和(56.7±17.0)h,差异无统计学意义(P=0.082).肠内营养组4例和静脉营养组3例患者出现恶心、腹胀或腹泻等胃肠道症状,均通过调慢输注速度和增加下床活动次数得以改善,两组胃肠道症状发生率的差异无统计学意义(P=1.000).结论食管癌术后24 h内早期肠内营养安全、可行,不会延缓术后肠功能恢复和增加患者早期胃肠道症状.
목적 탐토조기장내영양지지대식관암술후소장운동공능적영향.방법 전첨성입조2011년6-7월간북경대학종류의원흉외일과단일수술조수치적35례식관암수술환자,안수궤수자표법수궤분위조기장내영양조(20례)화조기정맥영양조(15례).술전진행영양풍험사사,술후24 h내대기분별급여정단백제제적장내영양화장외영양지지,감측환자장명음회복적시간급위장도증상.결과 장내영양조화정맥영양조술후장연동회복시간분별위(45.1±20.3)h화(56.7±17.0)h,차이무통계학의의(P=0.082).장내영양조4례화정맥영양조3례환자출현악심、복창혹복사등위장도증상,균통과조만수주속도화증가하상활동차수득이개선,량조위장도증상발생솔적차이무통계학의의(P=1.000).결론 식관암술후24 h내조기장내영양안전、가행,불회연완술후장공능회복화증가환자조기위장도증상.
Objective To assess the impact of early enteral nutrition (EN) on the intestinal motility of patients after esophagectomy.Methods Thirty-five consecutive patients undergoing esophagectomy for esophageal cancer by a single surgical team from the Peking University Cancer Hospital from June 2011 to July 2011 were enrolled.Patients were randomly divided into EN group (n=20) and parenteral nutrition group (control group,n=15) within 24 h after esophagectomy procedure.Bowel sound recovery time was monitored by auscultation,and the gastrointestinal tract symptoms were recorded.Results Bowel sound recovery time was (45.1±20.3) h in the EN group,and was (56.7±17.0) h in the control group (P=0.082).Gastrointestinal symptoms such as nausea,abdominal distension,diarrhea occurred in 4 patients in EN group and 3 patients in control group and were alleviated by lowering infusion speed and more off-bed ambulation,and no significant difference was seen between the two groups (P=1.000).Conclusions Early enteral nutrition in the patients after esophagectomy is safe and feasible.Early enteral nutrition does not delayed bowel function recovery or increase gastrointestinal symptoms.