目的 探討結(jié)直腸癌術(shù)后早期腸內(nèi)營(yíng)養(yǎng)的可行性、安全性及臨床療效。
方法 將50例結(jié)直腸癌術(shù)后患者隨機(jī)分為腸內(nèi)營(yíng)養(yǎng)(EN)治療組和腸外營(yíng)養(yǎng)(PN)治療組,均給予營(yíng)養(yǎng)支持治療至術(shù)后第7 d。 測(cè)定手術(shù)前、后的淋巴細(xì)胞計(jì)數(shù)(LC)、血清總蛋白(TP)、白蛋白(Alb)、前白蛋白(Pa)、轉(zhuǎn)鐵蛋白(Tf)、丙氨酸氨基轉(zhuǎn)移酶(ALT)及總膽紅素(TB)指標(biāo)的變化,同時(shí)觀察胃腸功能恢復(fù)時(shí)間。
結(jié)果 EN組的LC、TP、Alb、Pa、Tf、ALT與PN組差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05),TB低于PN組(t=2.45,P<0.05); EN組胃腸功能恢復(fù)時(shí)間早于PN組(t=8.60,P<0.001)。
結(jié)論 結(jié)直腸癌術(shù)后早期營(yíng)養(yǎng)支持應(yīng)首選EN。
引用本文: 李月春,王東霞,胡夏榮,葉鎮(zhèn)彭,陳桂林,王彤,王在國(guó). 結(jié)直腸癌術(shù)后早期腸內(nèi)營(yíng)養(yǎng)的應(yīng)用體會(huì). 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(8): 607-610. doi: 復(fù)制
1. | Rey-Ferro M, Castao R, Orozco O, et al. Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery [J]. Nutrition, 2007; 13(10)∶878. |
2. | Bozzetti F, Gavazzi C, Mariari L, et al. Artificial nutrition in cancer patients: with route, what composition [J]. World J Surg, 1999; 23(6)∶577. |
3. | 李江, 劉斌, 侯宇, 等. 腹部外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng)的臨床研究與應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(3)∶355. |
4. | 韓方海, 張肇達(dá), 伍曉汀, 等. 改良Welch手術(shù)在低位直腸癌超低位前切除術(shù)中的應(yīng)用 [J]. 中華胃腸外科雜志, 2003; 6(3)∶181. |
5. | Schroeder D, Gillanders L, Mahr K, et al. Effects of immediate postoperative enteral nutrition on body composition, muscle function, and wound healing [J]. JPEN J Parenter Enteral Nutr, 1991; 15(4)∶376. |
6. | Gennari R, Alexander JW. Effects of hyperoxia on bacterial translocation and mortality during gut-derived sepsis [J]. Arch Surg, 1996; 131(1)∶57. |
7. | Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review [J]. Crit Care Med, 2001; 299(12)∶2264. |
8. | 張珂, 吳剛, 李志偉, 等. 腸內(nèi)營(yíng)養(yǎng)在維護(hù)門(mén)靜脈高壓癥術(shù)后患者腸道黏膜屏障功能中的作用 [J]. 中國(guó)臨床營(yíng)養(yǎng)雜志,2003; 11(2)∶96. |
9. | 武正山, 錢(qián)建民, 孔連寶, 等. 肝移植術(shù)后早期腸內(nèi)營(yíng)養(yǎng)支持的臨床應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(3)∶255. |
10. | Kirby DF, Teran JC. Enteral feeding in critical care, gastrointestinal diseases, and cancer [J]. Gastrointest Endosc Clin N Am, 1998; 8(3)∶623. |
- 1. Rey-Ferro M, Castao R, Orozco O, et al. Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery [J]. Nutrition, 2007; 13(10)∶878.
- 2. Bozzetti F, Gavazzi C, Mariari L, et al. Artificial nutrition in cancer patients: with route, what composition [J]. World J Surg, 1999; 23(6)∶577.
- 3. 李江, 劉斌, 侯宇, 等. 腹部外科術(shù)后早期腸內(nèi)營(yíng)養(yǎng)的臨床研究與應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(3)∶355.
- 4. 韓方海, 張肇達(dá), 伍曉汀, 等. 改良Welch手術(shù)在低位直腸癌超低位前切除術(shù)中的應(yīng)用 [J]. 中華胃腸外科雜志, 2003; 6(3)∶181.
- 5. Schroeder D, Gillanders L, Mahr K, et al. Effects of immediate postoperative enteral nutrition on body composition, muscle function, and wound healing [J]. JPEN J Parenter Enteral Nutr, 1991; 15(4)∶376.
- 6. Gennari R, Alexander JW. Effects of hyperoxia on bacterial translocation and mortality during gut-derived sepsis [J]. Arch Surg, 1996; 131(1)∶57.
- 7. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review [J]. Crit Care Med, 2001; 299(12)∶2264.
- 8. 張珂, 吳剛, 李志偉, 等. 腸內(nèi)營(yíng)養(yǎng)在維護(hù)門(mén)靜脈高壓癥術(shù)后患者腸道黏膜屏障功能中的作用 [J]. 中國(guó)臨床營(yíng)養(yǎng)雜志,2003; 11(2)∶96.
- 9. 武正山, 錢(qián)建民, 孔連寶, 等. 肝移植術(shù)后早期腸內(nèi)營(yíng)養(yǎng)支持的臨床應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(3)∶255.
- 10. Kirby DF, Teran JC. Enteral feeding in critical care, gastrointestinal diseases, and cancer [J]. Gastrointest Endosc Clin N Am, 1998; 8(3)∶623.