CAJ | 학술논문

目的探讨食管癌切除术后早期应用肠内营养(EN)支持及护理的方法.方法 190例食管癌患者行食管次全切除及胃-食管颈部吻合,术中行鼻肠管留置,术后24h起给予肠内营养制剂百普力,并行相应护理.分别于术后EN前、EN第5天、第9天检测患者的血生化及营养指标,观察患者营养支持期间,有无腹痛,腹胀,恶心,呕吐,腹泻等胃肠道不良反应.结果所有患者术中均常规操作置入鼻肠管,未发生因导管留置引起的任何并发症,全组患者均能耐受早期肠内营养,无一例发生严重并发症.EN后营养评定指标白蛋白、转铁蛋白及前白蛋白水平较EN前有明显升高,差异有显著性(P＜0.05),体重、血红蛋白、丙氨酸氨基转移酶及总胆红素无显著差异(P＞0.05).结论食管癌术后早期肠内营养可有效改善患者营养状况,促进康复.规范化护理是保障肠内营养顺利完成的关键,可有效减少并发症的发生率.
목적 탐토식관암절제술후조기응용장내영양(EN)지지급호리적방법.방법 190례식관암환자행식관차전절제급위-식관경부문합,술중행비장관류치,술후24h기급여장내영양제제백보력,병행상응호리.분별우술후EN전、EN제5천、제9천검측환자적혈생화급영양지표,관찰환자영양지지기간,유무복통,복창,악심,구토,복사등위장도불량반응.결과 소유환자술중균상규조작치입비장관,미발생인도관류치인기적임하병발증,전조환자균능내수조기장내영양,무일례발생엄중병발증.EN후영양평정지표백단백、전철단백급전백단백수평교EN전유명현승고,차이유현저성(P＜0.05),체중、혈홍단백、병안산안기전이매급총담홍소무현저차이(P＞0.05).결론 식관암술후조기장내영양가유효개선환자영양상황,촉진강복.규범화호리시보장장내영양순리완성적관건,가유효감소병발증적발생솔.
Objective To investigate the method and effect of early enteral nutrition apphed in patients with esophageal cancer and summarize nursing experience.Methods A total of 190 patients with esophageal cancer had a naso-jejunal tube inserted during the operation and received early enteral nutrition after operation.Peptison were infused 24 hours since the postoperative day,Serum concentration of albumin,prealbumin were examined before enteral nutrition and on the 5th,9th,postoperative day.The recovery of bowel movement and other digestive symptoms such as abdominal pain,distension,diarrhea,nausea and vomiting were observed during the period of study.Results Compared before enteral nutrition,the concentration of prealbumin,serum albumin,prealbumin and transferrin were significantly elevated after nutritional support in EN group (P ＜ 0.05).No severe complications occurred.However,body weight,HGb and the serum level of ALT and TBIL showed no significant changes (P ＞ 0.05).Conclusions Early enteral nutrition can improve the nutritional status of patients with esophageal cancer and reduce the occurence of serious postoperative complication.So,early postoperative enteral nutrition is safe,effective and economical after esophageal cancer surgery.