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[目的]观察围手术期使用肠内营养液对食管及胃底贲门癌患者营养状态和炎性反应影响。[方法]我院2007年1月1日至2010年12月31日间因食管及胃底贲门癌拟行手术治疗患者,随机分为两组:A组,术前及术后双程肠内营养组(n=47);B组,术后单程肠内营养组(n=41)。A组术前10d辅助使用肠内营养制剂补充能量,3d内达到400ml/d并维持至术前1d。术后24h两组均使用肠内营养制剂,3d内达到400ml/d并维持至术后7d,辅以肠外营养支持。术前10d、1d,术后第1d、8d检测血清白蛋白、转铁蛋白、血清IL-6和血清C反应蛋白(CRP)浓度。[结果]两组患者术前10d时均有营养不良表现,A组患者经过辅助肠内营养支持,术前1d营养状况较B组明显改善(P<0.05);两组患者术前炎性反应差异无显著性差异(P>0.05)。术后第1d、8d的A组比B组血清白蛋白、转铁蛋白浓度显著增加(P<0.05),血清IL-6、CRP浓度显著下降(P<0.01)。[结论]食管及胃底贲门癌合并营养不良的患者围手术期使用双程肠内营养可以改善围手术期营养不良情况,缓解急性炎性反应。
[Objective] To observe the effect of enteral nutrition solution on nutritional status and inflammatory response in patients with esophageal and gastric cardia and gastric cardia during perioperative period. [Methods] Patients in our hospital from January 1, 2007 to December 31, 2010 due to esophageal and gastric cardia cancer surgery were randomly divided into two groups: group A, preoperative and postoperative enteral Nutritional group (n = 47); Group B, one-way enteral nutrition group (n = 41). A group supplemented with enteral nutrition supplements 10d preoperatively, reached 400ml / d within 3d and maintained 1d preoperatively. At 24 hours after operation, enteral nutrition was used in both groups, reaching 400ml / d in 3d and maintaining to 7 days after operation, supplemented by parenteral nutrition support. Serum albumin, transferrin, serum IL-6 and serum C-reactive protein (CRP) concentrations were measured at preoperative 10d, 1d and postoperative 1d, 8d respectively. [Results] Both groups showed malnutrition on the 10th day before operation. The nutritional status of the patients in Group A was significantly improved 1 d after operation (P <0.05), and the patients in Group A had preoperative inflammatory response There was no significant difference (P> 0.05). Serum albumin and transferrin concentrations were significantly increased (P <0.05) and serum IL-6 and CRP levels were significantly decreased in group A at the first and eighth day after operation (P <0.01). [Conclusion] Perioperative use of enteral nutrition during perioperative period in esophageal and gastric cardia cancer patients with malnutrition can improve perioperative malnutrition and relieve acute inflammatory reaction.