中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
14期
6355-6357
,共3页
曹子昂%潘文标%梁而慷%钱晓哲
曹子昂%潘文標%樑而慷%錢曉哲
조자앙%반문표%량이강%전효철
肠道营养%空肠造口术%综合疗法
腸道營養%空腸造口術%綜閤療法
장도영양%공장조구술%종합요법
Enteral nutrition%Jejunostomy%Combined modality therapy
目的：研究食管癌患者经过重大手术以后，如何通过肠内营养改善机体营养状态，安全接受辅助放、化疗。方法2011年4月至2012年4月对40例（EN组）食管癌患者采取了针刺导管空肠造口（FKJ）模式的营养支持，并设立40例对照组。入组患者符合下述条件：（1）两组患者的基本情况和疾病病程有可比较性；（2）术中及术后无严重并发症；（3）EN组术后FKJ提供肠内营养≥2个月；（4）随访时间≥6个月。EN组术后带管出院，居家自行给以瑞代1000 ml/d，持续≥2个月。对照组术前及出院后均不提供肠内、外商品营养制剂。结果术后3个月EN组患者体重及血清总蛋白、白蛋白含量明显好于对照组（P＜0.05），但6个月时各项指标有所接近。EN组NK细胞、IgM和IgG均较对照组有所升高，但没有统计学意义。EN组完成辅助治疗的患者比例为89.65%，对照组为75%。后续治疗中EN组肺炎3例，腹泻7例；对照组肺炎4例，腹泻2例。结论 FKJ管道可以有效地长期的提高患者机体的营养状态，对顺利接受术后的各种辅助治疗有重要的意义。
目的：研究食管癌患者經過重大手術以後，如何通過腸內營養改善機體營養狀態，安全接受輔助放、化療。方法2011年4月至2012年4月對40例（EN組）食管癌患者採取瞭針刺導管空腸造口（FKJ）模式的營養支持，併設立40例對照組。入組患者符閤下述條件：（1）兩組患者的基本情況和疾病病程有可比較性；（2）術中及術後無嚴重併髮癥；（3）EN組術後FKJ提供腸內營養≥2箇月；（4）隨訪時間≥6箇月。EN組術後帶管齣院，居傢自行給以瑞代1000 ml/d，持續≥2箇月。對照組術前及齣院後均不提供腸內、外商品營養製劑。結果術後3箇月EN組患者體重及血清總蛋白、白蛋白含量明顯好于對照組（P＜0.05），但6箇月時各項指標有所接近。EN組NK細胞、IgM和IgG均較對照組有所升高，但沒有統計學意義。EN組完成輔助治療的患者比例為89.65%，對照組為75%。後續治療中EN組肺炎3例，腹瀉7例；對照組肺炎4例，腹瀉2例。結論 FKJ管道可以有效地長期的提高患者機體的營養狀態，對順利接受術後的各種輔助治療有重要的意義。
목적：연구식관암환자경과중대수술이후，여하통과장내영양개선궤체영양상태，안전접수보조방、화료。방법2011년4월지2012년4월대40례（EN조）식관암환자채취료침자도관공장조구（FKJ）모식적영양지지，병설립40례대조조。입조환자부합하술조건：（1）량조환자적기본정황화질병병정유가비교성；（2）술중급술후무엄중병발증；（3）EN조술후FKJ제공장내영양≥2개월；（4）수방시간≥6개월。EN조술후대관출원，거가자행급이서대1000 ml/d，지속≥2개월。대조조술전급출원후균불제공장내、외상품영양제제。결과술후3개월EN조환자체중급혈청총단백、백단백함량명현호우대조조（P＜0.05），단6개월시각항지표유소접근。EN조NK세포、IgM화IgG균교대조조유소승고，단몰유통계학의의。EN조완성보조치료적환자비례위89.65%，대조조위75%。후속치료중EN조폐염3례，복사7례；대조조폐염4례，복사2례。결론 FKJ관도가이유효지장기적제고환자궤체적영양상태，대순리접수술후적각충보조치료유중요적의의。
Objective To investigate the mechanism of improving nutrition status via enteral nutrition(EN) in esophageal carcinoma patients after radical surgery so that they can undergo chemotherapy and radiotherapy safety. Methods From April 2011to April 2012,80 patients with esophageal carcinoma were divided into two groups randomly, EN group 40 cases and control group 40 cases. Their physical condition and illness status were comparable and no serious perioperative complication. EN group patients received fine-needle cathter jejunostomy (FKJ) enteral nutrition support (Fresubin Diebetes 1000 ml per day) at least 2 months after surgery. There was no enteral or paraenteral support in control group before operation or out-patient. Results The content of serum total protein and albumin in EN group was higher than that in control group at 3 month after operation(P<0.05). The content was similar in two groups at 6 month after operation. The content of NK cell, IgM, IgG in EN group was a bit higher than that in control group, however, was not statistically significant. 89.65%patients of EN group and 75%patients of control group completed the adjuvant therapy successfully, but 3 cases of pneumonia and 7 cases of diarrhea occurred in EN group, 4 cases of pneumonia and 2 cases of diarrhea occurred in control group. Conclusion FKJ is a long-term effective treatment for improving the nutritional status of patient and helping them completing postoperative adjuvant therapy successfully.
