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目的:观察老年食管癌、贲门癌术后早期肠内营养的效果。方法:选择手术治疗的老年食管癌、贲门癌94例,分为早期肠内营养组(EEN组)44例和肠外营养组(PN组)50例。两组每天营养素摄入量相当,EEN组术后早期给予瑞素或瑞代(供糖尿病患者使用)经肠内营养管持续定速滴注;PN组给予由复方氨基酸、脂肪乳、葡萄糖、脂溶维生素、微量元素配成的全静脉营养混合液,经中心静脉导管持续定速滴注。比较两组术后胃肠功能恢复时间和营养状况,并观察不良反应发生情况。结果:EEN组术后肠鸣音恢复时间、肛门排气及排便时间均显著或非常显著短于PN组(P<0.05,P<0.01)。术后7天,两组体重与治疗前比较均差异不显著(P>0.05);EEN组清蛋白、前清蛋白水平均显著高于术前(P<0.05),血红蛋白、清蛋白、前清蛋白水平均显著高于PN组(P<0.05);PN组血红蛋白水平显著低于术前(P<0.05)。结论:老年食管癌、贲门癌术后进行早期肠内营养,在有效促进肠道功能恢复、改善机体营养状态方面优于肠外营养。
Objective: To observe the effect of early postoperative enteral nutrition in elderly patients with esophageal cancer and cardia cancer. Methods: A total of 94 elderly patients with esophageal and cardiac cancer who underwent surgery were divided into 44 cases of early enteral nutrition group (EEN group) and 50 cases of parenteral nutrition group (PN group). The daily intake of nutrients in the two groups was similar, and the EEN group was given continuous infusion of Reutin or Ruidei (for patients with diabetes mellitus) via enteral nutrition tube in the early postoperative period. The PN group was given continuous infusion of compound amino acids, fat emulsion, glucose, Vital vitamins, trace elements dubbed the whole vein nutrition mixture, the continuous infusion of the central venous catheter. The postoperative gastrointestinal function recovery time and nutritional status were compared between the two groups, and the incidence of adverse reactions was observed. Results: The postoperative bowel sound recovery time, anal exhaust and defecation time in EEN group were significantly or very significantly shorter than those in PN group (P <0.05, P <0.01). The level of albumin and albumin in EEN group was significantly higher than that before operation (P <0.05), and hemoglobin, albumin, pre-Qing (P <0.05). The hemoglobin level in PN group was significantly lower than that in PN group (P <0.05). Conclusion: The early enteral nutrition for esophageal cancer and cardia cancer is superior to parenteral nutrition in effectively promoting the recovery of intestinal function and improving the nutritional status of the body.