营养途径对食管癌围术期患者营养状况的影响

doi:10.16689/j.cnki.cn11-9349/r.2020.04.017

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (404 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨肠内营养与肠外营养对食管癌围术期患者的营养状况和并发症的影响。方法回顾性分析淮安市第二人民医院2017年1月至2018年6月食管癌手术治疗患者73例，根据营养干预途径不同分为全肠外营养组（TPN）23例和全肠内营养组（TEN）50例。TPN组给予静脉营养治疗，TEN组给予经鼻饲管（经鼻至空肠起始位置）肠内营养治疗。比较两组患者营养指标和免疫指标、术后肠道功能和安全性指标。结果两组患者就诊前后体重丢失、入院时血清白蛋白、淋巴细胞数组间比较，差异无统计学意义（P>0.05）。TPN组血清白蛋白和淋巴细胞数不同时间点整体比较，差异均具有统计学意义（P<0.05）。TEN组淋巴细胞数不同时间点整体比较，差异均具有统计学意义（P<0.05）。两组手术后组间比较，TEN组体重丢失幅度小于TPN组；TEN组术后72h、术后120h血清白蛋白均短于TPN组，TEN组术后120h淋巴细胞数高于TPN组；TEN组肛门排气时间和肠鸣音恢复时间均低于TPN组，差异均具有统计学意义（P<0.05）。两组不良反应和不良事件比较，差异无统计学意义（P>0.05）。结论对食管癌围术期患者而言，肠内营养的疗效总体优于肠外营养，且安全性无明显差异。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	余晶晶
	顾润环
	李晓洁
	刘红

关键词 ：肠内营养, 肠外营养, 食管癌围术期, 营养状况

Abstract：Objective To explore the effects of enteral nutrition and parenteral nutrition on the nutritional status and complications of patients with esophageal cancer during perioperative periodMethods 73 patients with esophageal cancer during perioperative period treated in the Second People's Hospital of Huai'an from January 2017 to June 2018 were retrospectively analyzed. They were divided into 23 cases in total parenteral nutrition (TPN) group and 50 cases in total enteral nutrition (TEN) group according to different ways of nutrition intervention. The TPN group was given intravenous nutritional, and the TEN group was given enteral nutritional via a nasal feeding tube (through the nose to the beginning of the jejunum). The nutritional and immune indexes, postoperative intestinal function and safety indexes in the two groups were compared.Results There was no significant difference in the weight loss, serum albumin and lymphocyte group between the two groups of patients on admission (P>0.05). The comparison of serum albumin and lymphocyte counts in the TPN group, and the comparison of lymphocytes in the TEN group at different time points showed statistically significant differences (P<0.05). The weight loss of TEN group was lower than that of TPN group, and the difference was statistically significant；Serum albumin at 72h and 120h after the surgery in the TEN group was lower than that in the TPN group, the lymphocytes at 120h after the surgery in the TEN group were higher than that in the TPN group, and the differences were statistically significant (P<0.05)；The recovery time of anal exhaustion and bowel sounds in the TEN group were shorter than those in the TPN group, and the differences were statistically significant (P<0.05). There was no significant difference in safety between the two groups (P>0.05).Conclusion For perioperative patients with esophageal cancer, total enteral nutrition is generally better than total parenteral nutrition, but total parenteral nutrition can quickly increase serum albumin levels.

Key words： Enteral nutrition therapy Parenteral nutrition therapy Perioperative period of esophageal cancer Nutritional status

通讯作者: 刘红，电子邮箱：2522429096@qq.com

引用本文:

余晶晶，顾润环，李晓洁，刘红. 营养途径对食管癌围术期患者营养状况的影响[J]. 肿瘤代谢与营养电子杂志, 2020, 7(4): 465-468.
Yu Jingjing, Gu Runhuan, Li Xiaojie, Liu Hong. Effects of different nutritional approaches on the nutritional status of patients with esophageal cancer during perioperative period. Electron J Metab Nutr Cancer, 2020, 7(4): 465-468.

1.STEENHAGEN E. Preoperative nutritional optimization of esophageal cancer patients［J］. J Thorac Dis, 2019, 11(5):S645-S653.
2.LAN X, LIU X, SUN J, et al. CircRAD23B facilitates proliferation and invasion of esophageal cancer cells by sponging miR-5095［J］. Biochem Biophys Res Commun, 2019, 516(2):357-364.
3.JEENE P M, VERMEULEN B D, ROZEMA T, et al. Short-course external beam radiotherapy versus brachytherapy for palliation of dysphagia in esophageal cancer: A matched comparison of two prospective trials［J］. J Thorac Oncol, 2020, 15(8):1361-1368.
4.QIU Y, YOU J, WANG K, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial［J］. Nutrition, 2020, 69:110558.
5.谢琪, 王强, 雷敏, 等. 术前预康复对食管癌患者术后营养指标, 人体体成分, 血糖, 炎症反应和免疫功能的影响［J］. 临床误诊误治, 2019, 32(12):87-93.
6.HIKAGE M, TANIYAMA Y, SAKURAI T, et al. The influence of the perioperative nutritional status on the survival outcomes for esophageal cancer patients with neoadjuvant chemotherapy［J］. Ann Surg Oncol, 2019, 26(13):4744-4753.
7.李涛, 李宝生, 吕家华, 等. 食管癌患者营养治疗指南［J/CD］. 肿瘤代谢与营养电子杂志, 2020, 7(1):32-42.
8.LIAO M, XIA Z, HUANG P, et al. Early enteral feeding on esophageal cancer patients after esophageal resection and reconstruction［J］. Ann Palliat Med, 2020, 9(3):816-823.
9.梁吉振, 任云, 宫心明. 早期肠内营养联合肠外营养对食管癌患者术后营养状况及生活质量的影响［J］. 安徽医学, 2018, 39(1):110-112.
10.FURUTA M, YOKOTA T, TSUSHIMA T, et al. Comparison of enteral nutrition with total parenteral nutrition for patients with locally advanced unresectable esophageal cancer harboring dysphagia in definitive chemoradiotherapy［J］. Jpn J Clin Oncol, 2019, 49(10):910-918.
11.BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA Cancer J Clin, 2018, 68(6):394-424.
12.HONG H, LIU T, WU H, et al. MicroRNA-550a is associated with muscle system conferring poorer survival for esophageal cancer［J］. Biosci Rep, 2019, 39(5):BSR20181173.
13.陈茹, 郑荣寿, 张思维, 等. 2015年中国食管癌发病和死亡情况分析［J］. 中华预防医学杂志, 2019, 53(11):1094-1097.
14.PHELPS B J, TILEY Y M, SKROVE J L, et al. Acute dysphagia caused by sarcomatoid squamous cell carcinoma of the esophagus［J］. Cureus, 2019, 11(2):e4129.
15.OZE I, CHARVAT H, MATSUO K, et al. Revisit of an unanswered question by pooled analysis of eight cohort studies in Japan: Does cigarette smoking and alcohol drinking have interaction for the risk of esophageal cancer?［J］. Cancer Med, 2019, 8(14):6414-6425.
16.梁索原, 曹玉, 赤泽宏平, 等. 磁县食管癌高发区农村饮水中“三氮”含量的调查研究［J］. 中华肿瘤防治杂志, 2012, 19(9):649-651, 662.
17.XUE K S, TANG L, SUN G, et al. Mycotoxin exposure is associated with increased risk of esophageal squamous cell carcinoma in Huaian area, China［J］. BMC Cancer, 2019, 19(1):1218.
18.吕全军, 崔晗, 田亚兰, 等. 中国人群进食快对食管癌发病影响meta分析［J］. 中国公共卫生, 2018, 34(4):584-588.
19.ZHU Z Y, XU Y, LUO R J, et al.Clinical analysis of minimally invasive McKeown esophagectomy in a single center by a single medical group［J］. J Zhejiang Univ Sci B, 2018, 19(9):718-725.
20.吴波猛, 张海, 林万里, 等. 食管癌术后早期经口进食加速康复外科:单中心连续130例回顾性分析［J］. 中华生物医学工程杂志, 2018, 24(4):288-291.
21.SUNPAWERAVONG S, RUANGSIN S, LAOHAWIRIYAKAMOL S, et al. Prediction of major postoperative complications and survival for locally advanced esophageal carcinoma patients［J］.Asian J Surg, 2012, 35(3):104-109.
22.MURPHY K G, DHILLO W S, BLOOM S R. Gut peptides in the regulation of food intake and energy homeostasis［J］. Endocr Rev, 2006, 27(7):719-727.
23.孙启媛, 李治红, 龚小波. 腹部手术后进食时间对肠道功能恢复的影响［J］. 护士进修杂志, 2018, 33(13):1219-1220.
24.SOOP M, CARLSON G L, HOPKINSON J, et al. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol［J］. Br J Surg, 2004, 91(9): 1138-1145.
25.PENG J, CAI J, NIU Z X, et al. Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis［J］. Dis Esophagus, 2016, 29(4):333-341.
26.ELSHAER M, GRAVANTE G, WHITE J, et al. Routes of early enteral nutrition following oesophagectomy［J］. Ann R Coll Surg Engl, 2016, 98(7):461-467.
27.张旭刚, 李维青, 李宝重, 等. 基于倾向性评分匹配法比较食管癌术后早期肠内营养与肠外营养的疗效［J］. 中国肿瘤临床, 2019, 46(16):832-835.
28.STEENHAGEN E, VAN VULPEN J K, VAN HILLEGERSBERG R, et al. Nutrition in peri-operative esophageal cancer management［J］. Expert Rev Gastroenterol Hepatol, 2017, 11(7):663-672.
29.TALVAS J, GARRAIT G, GONCALVES-MENDES N, et al. Immunonutrition stimulates immune functions and antioxidant defense capacities of leukocytes in radiochemotherapy-treated head & neck and esophageal cancer patients: A double-blind randomized clinical trial［J］. Clin Nutr, 2015, 34(5):810-817.