贲门癌、食管癌术后早期肠内营养应用的体会(1)
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[摘要] 目的 探讨早期肠内营养(enteral nutrition，EN)在贲门癌、食管癌患者术后的实施方法与临床效果。方法 对132例贲门癌、食管癌患者在术中经鼻留置营养管，术后经鼻肠管给予EN治疗；对照组30例患者未进行肠内营养。结果 所有贲门癌、食管癌患者术中均顺利留置鼻十二指肠营养管，行肠内营养的患者吻合口瘘、肺部感染、切口感染、术后胃排空障碍等并发症的发生率较对照组明显减少，术后肛门排气和排便时间也明显缩短。结论 贲门癌、食管癌患者术后应用EN，能保护胃肠道黏膜屏障功能，促进胃肠功能恢复，提高机体免疫功能，增强抗感染能力，改善营养，减少费用，减少并发症的发生率，提高手术成功率，增强康复信心，是患者术后简便、安全、有效的营养补给法。
[关键词] 贲门癌；食管癌；十二指肠营养管；肠内营养
[中图分类号] R735 [文献标识码] B [文章编号] 1673-9701(2011)31-139-03
The Application of Early Enteral Nutrition Treatment in Postoperative Patients with Esophageal or Cardiac Cancer
WEI Xiangzhi ZHANG Ke WANG Yonghe YUE Qingfeng
Department of Thoracic Surgery, the Third People's Hospital of Hefei, Heifei 230022, China
[Abstract] Objective To study the implementation method and clinical effect of early enteral nutrition in postoperative patients with esophageal or cardiac cancer. Methods Nutrient canals were given through the nasal-intestinal tube in 132 cases with esophageal or cardiac cancer after operation. Control group of 30 patients were treated without enteral nutrition. Results The complications such as anastomotic leakage, lung infection, incisional infection and postoperative gastric emptying in the patients receiving early enteral nutrition were significantly reduced compared with the control group. The time for bowel function recovery was much shorter. Conclusion Early enteral nutrition can protect the gastrointestinal mucosa barrier, promote the recovery of gastrointestinal function, enhance immune function, increase anti-infection ability, improve nutrition, reduce costs, decrease the occurrence of complications, raise the successful rate of operation, enhance the confidence of rehabilitation, is simple, safe and effective nutrition supply method after surgery.
[Key words] Cardiac cancer; Esophageal cancer; Nutrient canals; Enteral nutrition
贲门癌、食管癌手术患者营养状况是手术治疗能否成功的重要因素之一。术后早期的营养支持对于患者的营养状态改善十分重要。目前认为，术后进行早期的肠内营养更有利于患者术后恢复，目前采取的方法多是于术中放置十二指肠营养管以进行肠内营养。2009年3月～2011年3月我们对132例贲门癌、食管癌切除术后患者经鼻十二指肠营养管进行肠内营养(肠内营养组)，效果满意；并选择2009年3月以前的30例贲门癌、食管癌患者未进行肠内营养(对照组)。现总结报道如下。
1 资料与方法
1.1 一般资料
两组患者男94例，女68例；年龄39～79岁，平均60.2岁。上段食管癌11例，中段食管癌68例，中下段食管癌36例，贲门癌47例。术前均经食管钡餐摄片、胃镜及病理活检证实为贲门癌或食管癌，肝肾功能等生化指标基本正常，术前均有不同程度体重减轻 ......
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