食管癌微创手术后患者早期经口进食对胃肠功能恢复及其营养状态的影响

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摘要目的探讨食管癌微创手术后患者早期经口进食对胃肠功能恢复及其营养状态的影响。方法选择2015-04至2020-04在大连大学附属中山医院接受微创手术治疗的84例原发性食管癌患者,采用随机数字表法分成早期经口组和晚期经口组,均为42例;掌握两组患者临床基本情况,对比分析术后首次排气和排便时间,测定手术当天,术后1、3、5 d血清胃泌素、胃动素水平,并测定术前及术后5 d机体营养指标,包括白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TRF),评估营养不良发生情况。结果两组患者临床基本情况差异无统计学意义(P＞0.05)。早期经口组术后首次排气时间为(2.04±0.72)d,排便时间为(3.38±1.15)d,晚期经口组分别为(3.10±0.84)d、(4.82±1.09)d,两组比较差异有统计学意义(P＜0.05)。术前、术后1 d两组患者血清胃泌素、胃动素水平均无统计学差异,术后3、5 d早期经口组均显著高于晚期经口组,差异有统计学意义(P＜0.05)。两组术前ALB、PAB、TRF水平无统计学差异,术后5 d早期经口组均显著高于晚期经口组(P＜0.05)。两组患者术后吻合口瘘发生率无统计学差异。早期经口组的营养不良发生率为16.67%,显著低于晚期经口组的30.95%,差异有统计学意义(P＜0.05)。结论早期经口进食有助于加快食管癌微创术后胃肠功能恢复,改善营养状态,加速术后康复。

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	史晓宇
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关键词 ：食管癌, 早期经口进食, 胃肠功能恢复, 营养状态

Abstract：Objective To investigate the effect of early oral feeding on the recovery of gastrointestinal function in patients with primary esophageal cancer after minimally invasive surgery, and to evaluate the nutritional status after surgery so as to provide data for the formulation of plans for accelerated rehabilitation surgery. Methods A total of 84 patients with primary esophageal cancer who had received minimally invasive surgery in our hospital between April 2015 and April 2020 were included in the study. These patients were randomly divided into the early oral feeding group and late oral feeding group,with 42 cases in each. The clinical data on the two groups of patients was collected while the time of the first postoperative exhaust and defecation was recorded. Serum levels of gastrin and motilin on the day of surgery and 1 d, 3 d, 5 d postoperatively were detected.The nutritional indexes of the body, including albumin (propagated), prealbumin (PAB)and transferrin (agency)before surgery and five days after surgery were recorded to find out about the incidence of malnutrition. Results There was no significant difference in basic clinical data between the two groups (P>0.05). The first postoperative exhaust time and defecation time were (2.04±0.72) d and (3.38±1.15) d respectively in the early oral feeding group, compared with (3.10±0.84) d and (4.82±1.09) d in the other group, so there was statistically significant difference between the two groups (P<0.05). There was no statistically significant difference in serum levels of gastrin and motilin between the two groups before surgery and 1 d after surgery,but these levels in the early oral feeding group were significantly higher than those of the late oral feeding group 3 d and 5d after surgery. The levels of ALB, PAB and TRF were not significantly different between the two groups before surgery, but they were significantly higher in the early oral feeding group than in the late oral feeding group 5 days after surgery (P<0.05). There was no significant difference in the incidence of postoperative anastomotic fistulas between the two groups. The incidence of malnutrition in the early oral feeding group was 16.67%, lower than (30.95%) in the late oral feeding group, and the difference was statistically significant (P<0.05). Conclusions Early oral feeding is of great clinical significance for accelerating gastrointestinal function recovery of patients with primary esophageal cancer after minimally invasive surgery,improving nutritional status,reducing the occurrence of malnutrition and accelerating postoperative recovery.

Key words： esophageal cancer early oral feeding gastrointestinal function recovery nutritional status

收稿日期: 2021-07-20

ZTFLH:	R735.1
	R655.4

通讯作者: 王慧卿,E-mail:sxy96181@126.com

作者简介: 史晓宇,硕士,主治医师。

引用本文:

史晓宇, 王慧卿. 食管癌微创手术后患者早期经口进食对胃肠功能恢复及其营养状态的影响[J]. 武警医学, 2022, 33(3): 207-210. SHI Xiaoyu, WANG Huiqing. Effects of early oral feeding on gastrointestinal function recovery and nutritional status in patients with esophageal cancer after minimally invasive surgery. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(3): 207-210.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2022/V33/I3/207

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