Comparison of Two Clinical Nutrition Supports in Patients with Esophageal Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

陈宇 , 陈保富 , 张波 , 叶中瑞 , 林江 , 叶敏华 , 马德华

浙江省台州医院（浙江临海 317000）;

Corresponding author：

Keywords：

食管癌术后; 肠内营养; 肠外营养

DOI：

10.7507/1007-4848.20160201

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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。

Citation： 陈宇, 陈保富, 张波, 叶中瑞, 林江, 叶敏华, 马德华. Comparison of Two Clinical Nutrition Supports in Patients with Esophageal Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 841-843. doi: 10.7507/1007-4848.20160201 Copy

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7.	Braga M, et al, Feeding the gut early after digestive surgery:results of a nine-year experience. Clin Nutr, 2002, 21(1):59-65.
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11.	康维明, 于健春, 马志强, 等.胃肠道手术后规范化序贯肠内肠外营养支持疗法与肠外营养支持的临床随机对照研究.中华临床营养杂志, 2011, 19(3):148-153.
12.	赵桂彬, 曹守强, 张凯, 等.快速康复外科对食管癌手术患者胰岛素抵抗指标的影响.中华临床营养杂志, 2012, 20(2):78-83.
13.	赵桂彬, 曹守强, 张凯, 等.早期肠内营养对食管癌患者术后免疫功能和临床结局的影响.中华胃肠外科杂志, 2014, 4:356-360.
14.	Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves posto-perative recovery in patients with gastric cancer:a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4):620-627.
15.	Wang LH, Fang F, Lu CM, et al. Safety of fast-track rehabilitation after gastrointestinal surgery:systematic review and meta-analysis. World J Gastroenterol, 2014, 20, 41:15423-15439.

1. Maturo G, Vespasiani G, Mohamed EI, et al. Evaluating body com-position of Italian prostate cancer patients without metastases. Acta Diabetol, 2003, 40(Suppl 1):S168-S170.
2. Norman K, Pichard C, Lochs H, et al, Prognostic impact of disease-related malnutrition. Clin Nutr, 2008, 27(1):5-15.
3. Takagi K, Yamamori H, Morishima Y, et al, Preoperative immuno-suppression:its relationship with high morbidity and mortality in patients receiving thoracic esophagectomy. Nutrition, 2001, 17(1):13-17.
4. 刘超群, 李欣, 浦江, 等.早期肠内营养对晚期食管癌患者的临床应用评价.中国综合临床, 2013, 29(9):953-956.
5. 黎介寿.临床营养支持的发展趋势.肠外与肠内营养, 2010, 17(1):1-4.
6. Pomposelli JJ, Flores E, Hirschberg Y, et al, Short-term TPN containing n-3 fatty acids ameliorate lactic acidosis induced by endotoxin in guinea pigs. Am J Clin Nutr, 1990, 52(3):548-552.
7. Braga M, et al, Feeding the gut early after digestive surgery:results of a nine-year experience. Clin Nutr, 2002, 21(1):59-65.
8. Heidegger CP, Romand JA, Treggiari MM, et al. Is it now time to promote mixed enteral and parenteral nutrition for the critically ill patient? Intensive Care Med, 2007, 33(6):963-969.
9. Aiko S, Yoshizumi Y, Sugiura Y, et al. Beneficial effects of immediate enteral nutrition after esophageal cancer surgery. Surg Today, 2001, 31(11):971-978.
10. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding:a systematic review and meta-analysis. J Gastrointest Surg, 2009, 13(3):569-575.
11. 康维明, 于健春, 马志强, 等.胃肠道手术后规范化序贯肠内肠外营养支持疗法与肠外营养支持的临床随机对照研究.中华临床营养杂志, 2011, 19(3):148-153.
12. 赵桂彬, 曹守强, 张凯, 等.快速康复外科对食管癌手术患者胰岛素抵抗指标的影响.中华临床营养杂志, 2012, 20(2):78-83.
13. 赵桂彬, 曹守强, 张凯, 等.早期肠内营养对食管癌患者术后免疫功能和临床结局的影响.中华胃肠外科杂志, 2014, 4:356-360.
14. Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves posto-perative recovery in patients with gastric cancer:a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4):620-627.
15. Wang LH, Fang F, Lu CM, et al. Safety of fast-track rehabilitation after gastrointestinal surgery:systematic review and meta-analysis. World J Gastroenterol, 2014, 20, 41:15423-15439.

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