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目的探讨结直肠癌腹腔镜手术病人围手术期肠内营养支持的可行性、有效性及必要性。方法将73例拟行腹腔镜下结直肠癌切除术病人随机分为肠内营养组(实验组,n=37)及肠外营养组(对照组,n=36)。比较两组病人术前第3d及术后第7d体重(WT)、血红蛋白(HB)、白蛋白(ALB)、总蛋白(TB)及总淋巴细胞计数(TLC)变化;记录术中肠道清洁程度、术后肛门或造口排气排便时间及住院天数;观察消化道不良反应及统计并发症的发生例数。结果对照组内各项营养指标术后7d较术前3d均明显降低(P<0.05),而实验组内只有TLC降低明显(P<0.05),ALB及TLC在实验组手术前后的降幅较对照组明显减少(P<0.05);实验组肛门或造口排气时间比对照组明显提前(P<0.05),对照组术后不良反应总体发生率显著高于实验组(44.4%比21.6%,P<0.05);两组肠道清洁度和并发症无显著性差异。结论围手术期肠内营养支持可改善腹腔镜下结直肠癌切除病人的预后。
Objective To investigate the feasibility, effectiveness and necessity of perioperative enteral nutrition in patients undergoing laparoscopic surgery of colorectal cancer. Methods 73 patients undergoing laparoscopic resection of colorectal cancer were randomly divided into enteral nutrition group (experimental group, n = 37) and parenteral nutrition group (n = 36). The changes of body weight (WT), hemoglobin (HB), albumin (ALB), total protein (TB) and total lymphocyte count (TLC) Degree, postoperative anorectal or stoma exhaust defecation time and hospital stay; observed the number of adverse reactions and statistical complications of the digestive tract. Results The indexes of nutrition in control group decreased significantly (P <0.05) on day 7 postoperatively compared with that on preoperative day 3, while only TLC decreased significantly in experimental group (P <0.05). Compared with control group, ALB and TLC decreased significantly (P <0.05). The anus or stoma exhaust time in the experimental group was significantly earlier than that in the control group (P <0.05), and the overall incidence of postoperative adverse reactions in the control group was significantly higher than that in the experimental group (44.4% vs. 21.6% P <0.05). There was no significant difference in intestinal cleanliness and complications between the two groups. Conclusion Perioperative enteral nutrition can improve the prognosis of patients undergoing laparoscopic resection of colorectal cancer.