CAJ | 학술논문

目的：探讨早期肠内营养在食管癌手术患者中的应用及临床效果。方法选取2012年1月至2013年12月在聊城市第三人民医院胸外科行食管癌手术的患者80例，按随机数字表法分成观察组和对照组，每组40例。观察组通过空肠鼻肠管给予百普力肠内营养支持，对照组给予肠外营养支持。观察指标包括：术后排气时间、排便时间、进流质饮食的时间、进半流质饮食的时间、住院时间及并发症；术前1天及术后第7天血红蛋白、总蛋白、白蛋白及前白蛋白水平。结果观察组和对照组术后排气时间分别为（3.12±1.14）d 、（4.69±1.32）d，术后排便时间分别为（4.33±1.27）d 、（5.69±1.54）d，进流质饮食的时间分别为（5.16±1.35）d 、（6.32±1.65）d，进半流质饮食的时间分别为（8.11±1.67）d 、（9.77±1.82）d，住院时间分别为（13.63±2.43）d 、（13.63±2.43）d，观察组均明显短于对照组，差异均有统计学意义（P ﹤0.05）；观察组与对照组术前1天的血红蛋白、总蛋白、白蛋白及前白蛋白水平比较差异无统计学意义（P ﹥0.05），术后第7天观察组营养状况较术前1天明显改善，并明显优于对照组，差异有统计学意义（P ﹤0.05）；观察组并发症发生率明显低于对照组，差异有统计学意义（P ﹤0.05）。结论食管癌手术术后早期给予肠内营养不仅可以缩短消化道功能的恢复时间，还可以显著改善患者的营养状况，是食管癌手术后安全、有效的营养支持方式。
목적：탐토조기장내영양재식관암수술환자중적응용급림상효과。방법선취2012년1월지2013년12월재료성시제삼인민의원흉외과행식관암수술적환자80례，안수궤수자표법분성관찰조화대조조，매조40례。관찰조통과공장비장관급여백보력장내영양지지，대조조급여장외영양지지。관찰지표포괄：술후배기시간、배편시간、진류질음식적시간、진반류질음식적시간、주원시간급병발증；술전1천급술후제7천혈홍단백、총단백、백단백급전백단백수평。결과관찰조화대조조술후배기시간분별위（3.12±1.14）d 、（4.69±1.32）d，술후배편시간분별위（4.33±1.27）d 、（5.69±1.54）d，진류질음식적시간분별위（5.16±1.35）d 、（6.32±1.65）d，진반류질음식적시간분별위（8.11±1.67）d 、（9.77±1.82）d，주원시간분별위（13.63±2.43）d 、（13.63±2.43）d，관찰조균명현단우대조조，차이균유통계학의의（P ﹤0.05）；관찰조여대조조술전1천적혈홍단백、총단백、백단백급전백단백수평비교차이무통계학의의（P ﹥0.05），술후제7천관찰조영양상황교술전1천명현개선，병명현우우대조조，차이유통계학의의（P ﹤0.05）；관찰조병발증발생솔명현저우대조조，차이유통계학의의（P ﹤0.05）。결론식관암수술술후조기급여장내영양불부가이축단소화도공능적회복시간，환가이현저개선환자적영양상황，시식관암수술후안전、유효적영양지지방식。
Objective To investigate the application and clinical effect of early enteral nutrition in patients with esophagus cancer radical surgery. Methods Eighty patients from January 2012 to De-cember 2013 in department of thoracic surgery of the third people’s hospital of Liaocheng were divided into observation group and control group,40 cases in each group,according to random number table method. The patients in observation group were given peptison enteral nutrition support through the jeju-num fistula,and the patients in control group were given parenteral nutrition support. Observation inde-xes including postoperative exhaust time,defecation time,eating liquid diet time,eating semi-liquid diet time,length of hospital stay and complications;the hemoglobin,total protein,albumin and prealbumin of preoperative l day and postoperative 7 day was recorded. Results The postoperative exhaust time of the observation group and control group respectively was(3. 12 ± 1. 14)d and(4. 69 ± 1. 32)d,postop-erative defecation time respectively was(4. 33 ± 1. 27)d and(5. 69 ± 1. 54)d,the eating liquid diet time respectively was(5. 16 ± 1. 35)d and(6. 32 ± 1. 65)d,the eating semi-liquid diet time respec-tively was(8. 11 ± 1. 67)d and(9. 77 ± 1. 82)d,length of hospital stay respectively was(13. 63 ± 2. 43)d and(13. 63 ± 2. 43)d,that in the observation group was significantly shorter than that in the control group,the differences were significant(P ﹤ 0. 05);there was no significant difference in the he-moglobin,total protein,albumin or prealbumin level of the two groups preoperative l day,the nutritional status of observation group postoperative 7 day improved significantly compared with preoperative 1 day, and was superior to control group,the differences were significant(P ﹤ 0. 05);The incidence of compli-cations in observation group was obviously lower than that in the control group,the difference was signifi-cant(P ﹤ 0. 05). Conclusions Early enteral nutrition can not only shorten the recovery time of diges-tive tract function of patients who had esophagus cancer radical surgery,but also can significantly improve the nutritional status of patients,is a safe and effective way of nutritional support.