CAJ | 학술논문

目的：探讨食管癌患者术中营养管放置和围术期营养支持的实施方法与临床效果。方法：2012年1月至2013年12月单手术组513例食管癌手术患者术中均常规放置营养管，其中鼻肠管497例，空肠造瘘16例。术后24 h后经鼻肠管给予肠内营养（enteral nutrition，EN）治疗，并辅以肠外营养（parenteral nutrition，PN）治疗，至全量EN后停PN支持。结果：所有患者均顺利放置营养管，在观察期间无死亡、无营养代谢障碍。鼻肠管组吻合口瘘、肺部并发症及切口感染发生率与空肠造瘘组比较无显著性差异（P>0.05）；空肠造瘘组肠梗阻发生率高于鼻肠管组患者（P<0.05）。结论：食管癌患者术中有效放置鼻肠管及早期应用EN为食管癌术后安全有效的营养补给方法。
목적：탐토식관암환자술중영양관방치화위술기영양지지적실시방법여림상효과。방법：2012년1월지2013년12월단수술조513례식관암수술환자술중균상규방치영양관，기중비장관497례，공장조루16례。술후24 h후경비장관급여장내영양（enteral nutrition，EN）치료，병보이장외영양（parenteral nutrition，PN）치료，지전량EN후정PN지지。결과：소유환자균순리방치영양관，재관찰기간무사망、무영양대사장애。비장관조문합구루、폐부병발증급절구감염발생솔여공장조루조비교무현저성차이（P>0.05）；공장조루조장경조발생솔고우비장관조환자（P<0.05）。결론：식관암환자술중유효방치비장관급조기응용EN위식관암술후안전유효적영양보급방법。
Objective:This study aims to investigate the method and clinical outcomes of feeding tube placement and periopera-tive nutritional support for esophageal carcinoma patients. Methods:A total of 513 esophageal carcinoma patients who have undergone radical resection and reconstruction by a single operating group between January 2012 and December 2013 participated this study. Feed-ing tubes were inserted via the nasal path of 497 cases and by jejunostomy in 16 cases. Early enteral nutrition (EN) was administered through the feeding tubes 24 h postoperatively with a stepwise increase, whereas supplementation of parenteral nutrition (PN) was ter-minated until total EN. Results:Feeding tubes were successfully inserted in all patients during operation. No death or nutritional and metabolic disorders were documented during the observation period. No differences in anastomotic fistula, pulmonary complication, and incision infection were identified between the nasointestinal and jejunostomy groups (P>0.05). A higher incidence of intestinal ob-struction was observed in the jejunostomy group than in the nasointestinal group (P<0.05). Conclusion:Effective placement of nasoin-testinal tube and early enteral feeding are safe and effective methods for patients who have undergone esophagectomy for esophageal carcinoma.