文章摘要
马 宁,李国栋.FTS理念下早期肠内营养在结直肠癌手术患者治疗中的临床观察[J].南京医科大学学报,2018,(4):505~508,513
FTS理念下早期肠内营养在结直肠癌手术患者治疗中的临床观察
Early enteral nutrition in postoperative patients with colorectal cancer under the concept of FTS
投稿时间:2017-11-11  
DOI:10.7655/NYDXBNS20180416
中文关键词: 早期肠内营养  结直肠癌  加速康复外科
英文关键词: early enteral nutrition  colorectal cancer  fast track surgery
基金项目:
作者单位
马 宁 南京医科大学附属南京医院(南京市第一医院)普外科江苏 南京 210006 
李国栋 南京医科大学附属南京医院(南京市第一医院)普外科江苏 南京 210006 
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中文摘要:
      目的:基于加速康复外科(fast track surgery,FTS)理论,探讨对结直肠癌患者进行早期肠内营养的疗效。方法:将62例结直肠癌患者随机分为早期肠内营养组(EEN组,n=31)和肠外营养组(PN组,n=31)。EEN组术前7 d开始给予肠内营养支持,术后早期肠内营养支持,PN组术前不干预,术后常规肠外营养支持。比较两组患者术前7 d、术前1 d和术后7 d的营养指标、炎性指标、免疫指标和术后患者排气排便时间及并发症发生情况。结果:术前1 d,EEN组患者血清白蛋白、前白蛋白、白介素?6、CD8+、CD4+/CD8+指标趋势皆优于PN组(P < 0.05);术后7 d,EEN组患者血清总蛋白、白蛋白、前白蛋白、C反应蛋白、白介素?6、肿瘤坏死因子?α、CD3+、CD4+、CD8+、CD4+/ CD8+指标趋势皆优于PN组(P < 0.05),并且EEN组患者术后排气排便时间明显短于PN组(P < 0.05),两组间并发症发生情况无显著差异。结论:早期肠内营养能够改善结直肠癌患者的营养状况、抑制炎症、提高免疫功能和促进胃肠功能恢复,是结直肠癌围手术期快速康复的有效方法之一。
英文摘要:
      Objective:To investigate the effect of early enteral nutrition on colorectal cancer patients based on the concept of fast track surgery(FTS). Methods:The patients with colorectal cancer were randomly divided into the early enteral nutrition group(the EEN group,n=31)and the parenteral nutrition group(the EN group,n=31),the EEN Group was given enteral nutrition support 7 days before operation and early enteral nutrition support after operation,the PN group was not intervened before operation and was given parenteral nutrition support after operation. The nutritional,inflammatory and immunity parameters,postoperative defecation time and complications were compared between the two groups at 7 days,1 day before operation and 7 days after operation. Results:One day before surgery,albumin(ALB),prealbumin(PA),interleukin 6(IL?6),CD8+,CD4+/ CD8+ parameters in the EEN group were better than those of the PN group(P < 0.05);7 days after operation,totalprotein(TP),ALB,PA,C?reactive protein(CRP),IL?6,tumor necrosis factor?α(TNF?α),CD3+,CD4+,CD8+,CD4+/ CD8+ parameters in the EEN group were better than those of the PN group(P < 0.05). The postoperative defecation time of the patients in the EEN group was significantly shorter than that of the PN group(P < 0.05)and complications had no significant difference between groups. Conclusion:Early enteral nutrition in patients with colorectal cancer can improve the nutritional status and immune function,inhibit inflammation and promote the recovery of gastrointestinal function. It is one of the effective routes for fast track surgery for colorectal cancer.
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