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目的分析食管癌患者术后早期实施肠内营养耐受性情况。方法回顾性分析潍坊医学院附属医院胸外科自2009年10月-2012年12月间的136例食管癌手术患者(47~69岁)实施肠内营养的耐受情况,根据患者达到目标热卡[25 kcal/(kg·d)]的时间分为3组:5天内达标组、6~10天内达标组及未达标组。统计各组达标比例、肠内营养常见并发症的发生情况、术后恢复情况,检测患者实施肠内营养第1天、第8天血清清蛋白(ALB)、前白蛋白(PA)及总蛋白(TP)等指标。结果 5天内达到目标热卡的患者92例(67.6%),6~10天内达到目标热卡的患者34例(25%),未达到目标热卡的患者10例(7.4%);5天内达标组肠内营养常见并发症的发生百分比明显低于其他组(P<0.05),术后肠蠕动的恢复时间、肛门排气排便时间和住院时间均较其他组短(P<0.05)。达标组患者第8天检测的ALB、PA、TP指标水平比未达标组明显增高(P<0.05)且5天内达标组的检测结果优于6~10天内达标组(P<0.05)。结论食管癌患者术后早期实施肠内营养5天内达到目标热卡的耐受性良好,营养治疗的效果明显。
Objective To analyze the early enteral nutrition tolerance in esophageal cancer patients after operation. Methods Thirty-six patients with esophageal cancer (47-69 years old) undergoing esophageal cancer surgery at Department of Thoracic Surgery, Affiliated Hospital of Weifang Medical College from October 2009 to December 2012 were retrospectively analyzed. According to the patients’ [25 kcal / (kg · d)] were divided into 3 groups: the target group within 5 days, the target group between 6 and 10 days, and the non-compliance group. Statistics of the proportion of the standard group, the incidence of common complications of enteral nutrition, postoperative recovery, detection of patients enteral nutrition day 1, day 8 serum albumin (ALB), prealbumin (PA) and total protein (TP) and other indicators. Results 92 patients (67.6%) reached the target fever card within 5 days, 34 patients (25%) reached the target fever card within 6 ~ 10 days and 10 patients (7.4%) did not reach the target heat card. The target reached within 5 days The incidence of common complications in enteral nutrition group was significantly lower than that in other groups (P <0.05). The recovery time of intestinal peristalsis, anal defecation time and hospital stay were shorter than those in other groups (P <0.05). The levels of ALB, PA and TP in the patients on the 8th day in the standard group were significantly higher than those in the non-compliance group (P <0.05). The detection results of the standard group within 5 days were better than those of the standard group within 6 to 10 days (P <0.05). Conclusions Esophageal cancer patients with early enteral nutrition within 5 days after the target fever card to achieve good tolerance, nutrition treatment effect is obvious.