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目的:探讨食管癌病人术后早期肠内营养的可行性、安全性和临床疗效。方法:将58例食管癌病人随机分为早期肠内营养(EEN,n=30)组和全肠外营养(TPN,n=28)组,两组均行营养支持8 d。所有病人在手术前1 d、术后第9天分别测定营养指标、免疫指标、肝功能、体重等,并观察肠功能恢复情况、术后并发症、住院费用和住院时间等。结果:所有病人在观察期间无严重并发症。术后第9天,两组病人体重均低于术前,而TPN组病人下降更明显(P<0.05);EEN组病人前清蛋白、转铁蛋白和IgA术后恢复程度明显好于TPN组(P<0.05);TPN组的ALP升高较EEN组明显(P<0.05);EEN组病人肠蠕动功能恢复较快,肛门排气、排便时间明显早于TPN组(P<0.01);平均住院费用、住院时间亦较TPN组少(P<0.01,P<0.05)。结论:食管癌病人术后EEN安全可行,既能改善营养状态,维护和促进胃肠道功能,又能提高机体免疫功能,减少治疗费用。
Objective: To investigate the feasibility, safety and clinical efficacy of early postoperative enteral nutrition in patients with esophageal cancer. Methods: 58 cases of esophageal cancer patients were randomly divided into early enteral nutrition group (EEN, n = 30) and total parenteral nutrition group (TPN, n = 28). Nutritional support was given in both groups for 8 days. All patients were measured on the first day before operation and on the 9th day after operation. Nutritional indexes, immune indexes, liver function and body weight were measured. Intestinal function recovery, postoperative complications, hospitalization and hospital stay were also observed. Results: All patients had no serious complications during the observation period. On the 9th day after operation, the body weight of both groups was lower than that before operation, while the decline in TPN group was more obvious (P <0.05). The recovery of prealbumin, transferrin and IgA in EEN group was significantly better than TPN group (P <0.05). The ALP level in TPN group was significantly higher than that in EEN group (P <0.05). The recovery rate of intestinal peristalsis was faster in the EEN group than that in the TPN group (P <0.01) Hospitalization costs and hospital stay were also lower than those in the TPN group (P <0.01, P <0.05). Conclusion: Postoperative EEN is safe and feasible for patients with esophageal cancer, which can not only improve nutritional status, maintain and promote gastrointestinal function, but also improve immune function and reduce treatment costs.