老年食管癌术后病人肠内营养时间对其胃肠功能恢复的影响

doi:10.3969/j.issn.1003-9198.2021.11.012

摘要/Abstract

摘要： 目的探讨老年食管癌术后早期肠内营养对其胃肠功能恢复的影响。方法选择2017年8月至2018年8月我院收治的84例行食管癌根治术的老年病人为研究对象,随机分为2组。其中对照组在术后24~48 h内给予肠内营养,观察组在术后12 h内给予肠内营养。比较2组病人术后胃肠功能恢复及并发症发生情况。结果观察组病人术后1周血清白蛋白、前白蛋白和转铁蛋白水平均明显高于对照组,差异有统计学意义(P<0.05)。观察组病人术后初次排便时间、初次排气时间、肠鸣音恢复时间均较对照组明显缩短,差异有统计学意义(P<0.05)。2组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论老年食管癌术后早期12 h内给予肠内营养支持,可显著提高病人营养状况,促进胃肠功能恢复。

关键词: 食管癌, 肠内营养, 胃肠功能恢复, 并发症

Abstract: Objective To explore the effects of enteral nutrition time on gastrointestinal function recovery in the elderly patients with esophageal cancer. Methods A total of 84 elderly patients with esophageal cancer receiving surgery were selected from August 2017 to August 2018 in our hospital, and they were randomly divided into experimental group and control group. Patients in the control group was given enteral nutrition within 24-48 h after surgery, and the patients in the experimental group were given enteral nutrition within 12 h after surgery. The postoperative gastrointestinal function recovery and complications were compared between the two groups. Results The levels of serum albumin, prealbumin and transferrin one week after nutritional support in the experimental group were higher than those in the control group (P<0.05). The time of the first defecation, the first anal exhaust and the time of recovery of bowel sound after surgery in the experimental group were shorter than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the incidence rate of postoperative complications between the two groups (P>0.05). Conclusions Enteral nutrition intervention within 12 h after surgery can improve the nutritional state of the elderly patients with esophageal cancer, and promote the recovery of gastrointestinal function.

Key words: esophageal cancer, enteral nutrition, gastrointestinal function recovery, complication

中图分类号:

R 735.1

邢益辉, 刘曼, 张治. 老年食管癌术后病人肠内营养时间对其胃肠功能恢复的影响[J]. 实用老年医学, 2021, 35(11): 1154-1156.

XING Yi-hui, LIU Man, ZHANG Zhi. Effects of postoperative enteral nutrition time on gastrointestinal function recovery in the elderly patients with esophageal cancer[J]. Practical Geriatrics, 2021, 35(11): 1154-1156.

参考文献

[1] 毛友生,高树庚,王群,等.中国食管癌临床流行特征及外科治疗概况大数据分析[J]. 中华肿瘤杂志,2020,42(3):228-233.
[2] GHOSH S, ITTZES B, BOGAR L, et al. A comparison of pre-operative nutritional status with post-perative morbidity and mortality in obese esophageal surgery patients[J]. Adv Clin Exp Med, 2014, 23(5): 763-768.
[3] 胡月霞,林慕雅,王纯辉,等.全身麻醉复合胸段硬膜外麻醉对腔镜食管癌根治术患者胃肠功能的影响[J]. 山东医药,2019,59(2):55-57.
[4] 卢万里,朱正帅,裴书飞,等.食管癌患者胸腹腔镜术后呼吸道感染细胞因子变化[J]. 中华医院感染学杂志,2020,30(14):2169-2173.
[5] OYA H,KOIKE M,IWATA N,et al. Feeding duodenostomy decreases the incidence of mechanical obstruction after radical esophageal cancer surgery[J]. World J Surg,2015, 39(5):1105-1110.[6] MANZANARES W, LEMIEUX M, LANGLOIS P L,et al. Probiotic and synbiotic therapy in critical illness: a systematic review and meta-analysis[J]. Crit Care,2016, 19:262.
[7] PENG S, HUANG L, ZHAO B, et al. Clinical course of coronavirus disease 2019 in 11 patients after thoracic surgery and challenges in diagnosis[J]. J Thorac Cardiovasc Surg,2020, 160(2):585-592.
[8] 周轼瑜,慎华平,张国雷,等. 快速康复外科对肝胆外科手术患者炎性因子、胃肠激素及胃肠功能的影响[J]. 世界华人消化杂志, 2019, 27(5):305-310.
[9] SAGAR R C, VEERENDRA KUMAR K V, RAMACHANDRA C, et al. Perioperative artificial enteral nutrition in malnourished esophageal and stomach cancer patients and its impact on postoperative complications[J]. Indian J Surg Oncol, 2019, 10(3):460-464.
[10] 曲冬梅,刘军燕,李新成. 循证护理在重型颅脑损伤患者中的应用及效果观察[J]. 中国农村卫生, 2018, 8:62-63.
[11] 马经伟,王涛,吴波,等.食管癌术后早期肠内营养联合肠外营养与标准肠外营养支持的疗效对比[J]. 宁夏医科大学学报,2020,42(2):163-167.
[12] SHORES D R, ALAISH S M, AUCOTT S W, et al. Postoperative enteral nutrition guidelines reduce the risk of intestinal failure-associated liver disease in surgical infants[J]. J Pediatr, 2018, 195: 140-147.
[13] 李学新,武建凤,陈艳红,等.肠内营养联合益生菌对老年颅脑外伤患者营养状况和胃肠功能的影响[J]. 中国老年学杂志,2017,37(14):3465-3467.
[14] 蒋春霞,周群燕. 食管癌术后肠内营养的时机对胃肠功能恢复的影响[J]. 河北医药,2018,40(9):1386-1388.

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