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目的探讨食管癌术后早期肠内营养支持的可行性及其临床价值。方法将食管癌术后患者随机分为完全胃肠外营养支持组(TPN39例)和肠内营养支持组(EN39例)。TPN组术后行标准全胃肠外营养支持7d,EN组在术后第1天始经鼻肠管输入肠内营养夜。两组提供的热量和氮量基本相同。记录术后并发症、住院天数、胃肠功能恢复时间和营养支持花费情况,术后第1天及第8天监测总蛋白、白蛋白。结果两组患者无死亡、吻合口瘘等严重并发症,EN组肠功能恢复早于TPN,节约营养支持费用(P<0.05),两种方法营养支持疗效相近。结论食管癌术后早期EN的营养支持与TPN基本相同,肠功能恢复早,且操作方便和营养花费少。
Objective To investigate the feasibility and clinical value of early postoperative enteral nutrition support for esophageal cancer. Methods Patients with postoperative esophageal cancer were randomly divided into complete parenteral nutrition support group (TPN39 cases) and enteral nutrition support group (EN39 cases). The patients in TPN group received standard total parenteral nutrition support for 7 days after operation. In EN group, enteral nutrition was administered via nasal tube on the first day after operation. The two groups provide essentially the same amount of heat and nitrogen. Postoperative complications, length of hospital stay, recovery time of gastrointestinal function and nutritional support were recorded. Total protein and albumin were monitored on the first day and the eighth postoperative day. Results There were no serious complications such as death and anastomotic fistula in both groups. The EN function of intestine in EN group was earlier than that in TPN group, and the nutritional support was saved (P <0.05). The nutritional support of the two methods were similar. Conclusion The nutritional support of early EN after esophageal cancer is basically the same as that of TPN, the recovery of intestinal function is earlier, and it is easier to operate and consume less nutrients.