食管癌微创术后肠内营养治疗504例疗效分析
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摘要
[目的]评价食管癌微创术后早期肠内营养治疗患者的疗效及安全性。[方法]对504例食管癌微创术的患者,在术后24h内与24～48h中应用肠内营养管饲治疗,评估其营养状况。[结果]全组患者术后d8血清白蛋白、前蛋白的指标明显高于术后d1(P<0.05),体质指数术后d8高于术前d1(P<0.05)。患者肠内营养治疗后,耐受良好为72.82%,部分耐受为18.45%,主要不良反应是腹胀严重腹泻(8.73%),完成营养治疗目标量460例(91.27%)。[结论]食管癌术后24h内与24～48h中应用肠内营养具有较好的疗效,有效提高肠内营养的安全性与耐受性,改善了营养状况。
[Objective] To evaluate the efficacy and safety of early enteral nutrition in patients with minimally invasive radical surgery for esophageal cancer. [Methods] Five hundred and four patients with esophageal cancer received enteral nutrition tube feeding within 24 h and between 24 ～48 h after minimally invasive radical surgery. The nutritional status was assessed. [Results]The serum albumin and proprotein levels of patients on postoperative d8 were significantly higher than those on postoperative d1(P<0.05). There was significant difference in body mass index between postoperative d8 and preoperative d1(P<0.05). For enteral nutrition 72.82% patients were well tolerated and 18.45% were partial tolerated. The main adverse effects were abdominal distension and severe diarrhea(8.73%),and 460 patients(91.27%) completed the nutritional treatment. [Conclusion] Enteral nutrition within 24 h and between 24～48 h after minimally invasive esophageal cancer surgery is effective and safe to improve the nutritional status of patients.
[Objective] To evaluate the efficacy and safety of early enteral nutrition in patients with minimally invasive radical surgery for esophageal cancer. [Methods] Five hundred and four patients with esophageal cancer received enteral nutrition tube feeding within 24 h and between 24 ～48 h after minimally invasive radical surgery. The nutritional status was assessed. [Results]The serum albumin and proprotein levels of patients on postoperative d8 were significantly higher than those on postoperative d1(P<0.05). There was significant difference in body mass index between postoperative d8 and preoperative d1(P<0.05). For enteral nutrition 72.82% patients were well tolerated and 18.45% were partial tolerated. The main adverse effects were abdominal distension and severe diarrhea(8.73%),and 460 patients(91.27%) completed the nutritional treatment. [Conclusion] Enteral nutrition within 24 h and between 24～48 h after minimally invasive esophageal cancer surgery is effective and safe to improve the nutritional status of patients.
引文
[1]Hu J.Esophageal Cancer Nutrition Therapy[M].Hangzhou:Zhejiang University Press,2016.115-121.[胡坚.食管癌营养治疗[M].杭州:浙江大学出版社,2016.115-121.]
[2]Lazzarino AI,Nagpal K,Bottle A,et al.Open versous minimally invasive esophagectomy:trends of utilization and associate outcomes in England[J].Aun Surg,2010,252(2):292-298.
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[4]Liu J.Retreatment of 215 cases of advanced non-small cell lung cancer with ectinib[J].Journal of Chinese Oncology,2017,23(1):25-29.[刘俊.埃克替尼治疗215例复治晚期非小细胞肺癌[J].肿瘤学杂志,2017,23(1):25-29.]
[5]Zhu L,Gao C.Effect of enteral nutrition tolerance assessment on early enteral nutrition tolerance after gastric cancer operation[J].Modern Clinical Care,2015,14(7):18-22.[朱丽,高纯.肠内营养耐受性评估表对胃癌术后早期肠内营养耐受性的影响[J].现代临床护理,2015,14(7):18-22.]
[6]Yang Y,Zhang XB.Minimally invasive surgery of robotassisted esophageal cancer in 75 cases of Shanghai Chest Hospital[J].Journal of Chinese Thoracic Surgery,2016,3(3):151-155.[杨煜,张晓彬.机器人辅助食管癌的微创外科切除上海市胸科医院75例临床报道[J].中华胸部外科杂志,2016,3(3):151-155.]
[7]Guo JT,Liang ZY.Effect of early enteral nutrition on the recovery of gastrointestinal and immune function after esophageal cancer surgery[J].Journal of PLA Medical College,2016,37(10):1060-1063.[郭俊唐,梁朝阳.食管癌术后早期肠内营养对胃肠及免疫功能恢复的影响[J].解放军医学院学报,2016,37(10):1060-1063.]
[8]Fujita T,Daiko H,Nishimura M.Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomg in patients with esophageal cancer[J].Eur Surg Res,2012,48(2):79-84.
[9]Xue B.Clinical efficacy of postoperative enteral and parenteral nutrition support for esophageal cancer[J].Journal of Hebei Medical University,2017,38(4):484-486.[薛冰.食管癌术后肠内肠外营养支持临床疗效比较[J].河北医科大学学报,2017,38(4):484-486.]
[2]Lazzarino AI,Nagpal K,Bottle A,et al.Open versous minimally invasive esophagectomy:trends of utilization and associate outcomes in England[J].Aun Surg,2010,252(2):292-298.
[3]Lubos Sobotk,Cai W.Clinical Nutrition Foundation[M].4th Edition.Shanghai Jiaotong University Press,2013.23-26.[Lubos Sobotk主编,蔡威译.临床营养基础[M].第4版.上海:上海交通大学出版社,2013.23-26.]
[4]Liu J.Retreatment of 215 cases of advanced non-small cell lung cancer with ectinib[J].Journal of Chinese Oncology,2017,23(1):25-29.[刘俊.埃克替尼治疗215例复治晚期非小细胞肺癌[J].肿瘤学杂志,2017,23(1):25-29.]
[5]Zhu L,Gao C.Effect of enteral nutrition tolerance assessment on early enteral nutrition tolerance after gastric cancer operation[J].Modern Clinical Care,2015,14(7):18-22.[朱丽,高纯.肠内营养耐受性评估表对胃癌术后早期肠内营养耐受性的影响[J].现代临床护理,2015,14(7):18-22.]
[6]Yang Y,Zhang XB.Minimally invasive surgery of robotassisted esophageal cancer in 75 cases of Shanghai Chest Hospital[J].Journal of Chinese Thoracic Surgery,2016,3(3):151-155.[杨煜,张晓彬.机器人辅助食管癌的微创外科切除上海市胸科医院75例临床报道[J].中华胸部外科杂志,2016,3(3):151-155.]
[7]Guo JT,Liang ZY.Effect of early enteral nutrition on the recovery of gastrointestinal and immune function after esophageal cancer surgery[J].Journal of PLA Medical College,2016,37(10):1060-1063.[郭俊唐,梁朝阳.食管癌术后早期肠内营养对胃肠及免疫功能恢复的影响[J].解放军医学院学报,2016,37(10):1060-1063.]
[8]Fujita T,Daiko H,Nishimura M.Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomg in patients with esophageal cancer[J].Eur Surg Res,2012,48(2):79-84.
[9]Xue B.Clinical efficacy of postoperative enteral and parenteral nutrition support for esophageal cancer[J].Journal of Hebei Medical University,2017,38(4):484-486.[薛冰.食管癌术后肠内肠外营养支持临床疗效比较[J].河北医科大学学报,2017,38(4):484-486.]