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目的探讨两种不同途径的营养方式对食管癌患者术后恢复的影响。方法选取浙江省台州医院心胸外科2007~2011年63例食管癌患者术后的不同营养支持,分为肠内营养(enteral nutrition,EN)组(33例)和肠外营养(parenteral nutrition,PN)组(30例),比较两组的术后胃肠功能恢复、营养指标、并发症情况、住院费用、住院时间及肝功能等影响。结果 EN组与PN组的排气时间[(42.30±6.70)h vs.(60.60±15.60)h,P<0.01]、住院时间[(15.40±6.55)d vs.(21.00±10.57)d,P<0.01]、住院费用[(4.49±1.28)万元vs.(4.73±1.18)万元,P<0.01]差异均有统计学意义。两组术后均无吻合口漏等严重并发症,两组术后白蛋白水平较术前有不同程度下降,术后肝功能PN组较EN组变化大,两组差异有统计学意义(P<0.01)。结论两种营养方式均能改善患者的术后营养状况,但肠内营养更符合生理特点、廉价,适应现代营养支持,较静脉营养有优势。
Objective To investigate the effects of two different ways of nutrition on postoperative recovery of esophageal cancer patients. Methods Sixty-three patients with esophageal cancer were enrolled in the Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province from 2007 to 2011, and divided into enteral nutrition group (n = 33) and parenteral nutrition group (n = (30 cases). The effects of postoperative gastrointestinal function recovery, nutritional indices, complications, hospitalization costs, hospital stay and liver function were compared between the two groups. Results The duration of hospitalization [(15.40 ± 6.55) d vs. (21.00 ± 10.57) days, P (P <0.01), P <0.01]. The hospitalization cost [(4.49 ± 1.28) million vs. (4.73 ± 1.18) million, P <0.01] showed statistically significant differences. There were no severe complications such as anastomotic leakage in both groups after operation. The postoperative albumin levels in both groups decreased to some degree after operation. The postoperative functional changes in PN group were more significant than those in EN group (P <0.01). Conclusion Both nutritional methods can improve the postoperative nutritional status of patients, but enteral nutrition is more consistent with physiological characteristics, cheap, adapt to modern nutritional support, compared with the advantages of intravenous nutrition.