CAJ | 학술논문

目的：探讨早期肠内和肠外营养对结直肠癌患者术后恢复的影响。方法选取该院2012年12月-2014年12月收治的120例结直肠癌患者，分为肠内营养（Enteral nutrition，EN）组（40例）、肠外营养（Parenteral nutrition，PN）组（40例）和EN联合PN组（40例），分析比较各组患者营养指标、应激指标、免疫指标、术后并发症、胃肠道恢复时间、住院时间和治疗费用。结果3组患者术后，在营养指标上，EN联合PN组中PA、ALB和TF值均高于EN组和PN组（P<0.05），在应激指标上，EN联合PN组中CRP值低于EN组和PN组（P<0.05），EN组中CRP值低于PN组（P<0.05）；在免疫指标上，EN联合PN组中CD3、CD4和CD4/CD8百分比均高于EN组和PN组（P<0.05），EN组中CD3、CD4和CD4/CD8百分比均高于PN组（P<0.05）；在术后并发症上，EN联合PN组术后并发症发生率为5.0%，要显著低于PN组（20.0%）（P<0.05）；在胃肠道恢复时间和住院时间上，EN联合PN组均短于EN组和PN组（P<0.05），EN组短于PN组（P<0.05）；在治疗费用上，EN联合PN组少于EN组和PN组（P<0.05），EN组少于PN组（P<0.05）。结论在结直肠癌术后单纯EN效果好于PN，而EN联合PN营养支持较EN或PN能显著改善术后营养状况、提高免疫功能、减少术后并发症、促进胃肠道恢复、缩短住院时间和降低治疗费用，是一种理想的营养支持方案。
목적：탐토조기장내화장외영양대결직장암환자술후회복적영향。방법선취해원2012년12월-2014년12월수치적120례결직장암환자，분위장내영양（Enteral nutrition，EN）조（40례）、장외영양（Parenteral nutrition，PN）조（40례）화EN연합PN조（40례），분석비교각조환자영양지표、응격지표、면역지표、술후병발증、위장도회복시간、주원시간화치료비용。결과3조환자술후，재영양지표상，EN연합PN조중PA、ALB화TF치균고우EN조화PN조（P<0.05），재응격지표상，EN연합PN조중CRP치저우EN조화PN조（P<0.05），EN조중CRP치저우PN조（P<0.05）；재면역지표상，EN연합PN조중CD3、CD4화CD4/CD8백분비균고우EN조화PN조（P<0.05），EN조중CD3、CD4화CD4/CD8백분비균고우PN조（P<0.05）；재술후병발증상，EN연합PN조술후병발증발생솔위5.0%，요현저저우PN조（20.0%）（P<0.05）；재위장도회복시간화주원시간상，EN연합PN조균단우EN조화PN조（P<0.05），EN조단우PN조（P<0.05）；재치료비용상，EN연합PN조소우EN조화PN조（P<0.05），EN조소우PN조（P<0.05）。결론재결직장암술후단순EN효과호우PN，이EN연합PN영양지지교EN혹PN능현저개선술후영양상황、제고면역공능、감소술후병발증、촉진위장도회복、축단주원시간화강저치료비용，시일충이상적영양지지방안。
Objective To investigate the effect of early enteral and parenteral nutrition on colorectal cancer patients after opera-tion. Methods 120 cases of colorectal cancer patients in our hospital from 2012 December~2014 year in December, were divided into enteral nutrition (Enteral nutrition, EN) group (40 cases), parenteral nutrition (Parenteral nutrition, PN) group (40 cases) and EN+PN group (40 cases). The nutritional index, stress index, immunity index, postoperative complications, time of resumption of gastrointestinal function, hospitalization and treatment cost were compared between three groups. Results After operation, the nu-tritional index ( PA、ALB and TF )in EN combined with PN group were higher than EN and PN group (P<0.05); the stress index (CRP) in EN combined with PN group was lower than EN and PN group(P<0.05), in EN group was lower than PN group(P<0.05);the immunity index(CD3、CD4 and CD4/CD8) in EN combined with PN group were higher than EN and PN group(P<0.05), in EN group was higher than PN group(P<0.05);The postoperative complications in EN combined with PN group were less than PN group (P<0.05); the time of resumption of gastrointestinal function and hospitalization in EN combined with PN group were less than EN and PN group (P<0.05), in EN group was less than PN group(P<0.05);the treatment cost in EN combined with PN group were less than EN and PN group (P<0.05), in EN group was less than PN group(P<0.05). Conclusions The effect of EN on colorectal cancer patients after operation was better than PN. However, EN combined with PN compared with EN and PN on colorectal cancer pa-tients after operation could enhance significantly nutritional status, improve immune function, reduce postoperative complications, shorten the time of resumption of gastrointestinal function and hospitalization and decrease treatment cost. EN combined with PN was an ideal method of nutritional support.