Wang Dongsheng, Zhong Bei, Zhao Ping, Liu Xiaodong, Zhou Yanbing
Department of General Surgery, The Affiliated Hospital, Qingdao University, Qingdao 266003, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Oct;17(10):977-80.
To observe the safety and efficacy of early oral enteral nutrition after colorectal cancer operation.
A total of 88 colorectal cancer patients in our department from March 2013 to December 2013 were prospectively enrolled in the study and randomly divided into early enteral nutrition group(43 cases, receiving early water and enteral nutrition after operation) and early fasting group(45 cases, receiving conventional postoperative care protocol) based on the random number table. The postoperative recovery, complication morbidity, nutritional status and stress were compared between the two groups.
Compared to early fasting group, patients in early enteral nutrition group had a significantly shorter duration of postoperative fever [(53.7±5.9) h vs. (64.5±5.8) h, P<0.01], a shorter interval to flatus [(57.5±8.2) h vs. (71.8±7.2) h, P<0.01], a shorter hospital stay [(6.9±1.4) d vs. (8.5±1.9) d, P<0.01] and lower medical cost [(41 868±3168) Yuan vs. (45 950±3714) Yuan, P<0.01]. There was no significant difference in complication morbidity between the two groups [18.6%(8/43) vs. 22.2%(10/45), P>0.05]. The albumin, prealbumin, and retinol binding protein on the third and seventh postoperative days were significantly higher in early oral enteral nutrition group (P<0.05), while the rest energy expense (REE) and lnHOMA-IR were significantly lower as compared to early fasting group (all P<0.05).
Early oral enteral nutrition after colorectal cancer operation is safe and effective, which is a natural route of nutrition and can reduce the stress response related to surgery, improve postoperative patients' nutritional status and accelerate rehabilitation.
观察结直肠癌术后早期口服肠内营养的安全性和有效性。
前瞻性纳入2013年3月至2013年12月在我科住院的88例结直肠癌患者,根据随机数字表法将其随机分为早期肠内营养组(43例,术后早期给予水及肠内营养)和早期禁食组(45例,接受术后常规护理方案)。比较两组患者术后恢复情况、并发症发生率、营养状况及应激反应。
与早期禁食组相比,早期肠内营养组患者术后发热持续时间明显缩短[(53.7±5.9)小时对(64.5±5.8)小时,P<0.01],排气时间间隔缩短[(57.5±8.2)小时对(71.8±7.2)小时,P<0.01],住院时间缩短[(6.9±1.4)天对(8.5±1.9)天,P<0.01],医疗费用降低[(41 868±3168)元对(45 950±3714)元,P<0.01]。两组并发症发生率差异无统计学意义[18.6%(8/43)对22.2%(10/45),P>0.05]。术后第3天和第7天,早期口服肠内营养组患者的白蛋白、前白蛋白和视黄醇结合蛋白水平明显升高(P<0.05),而静息能量消耗(REE)和lnHOMA-IR水平明显低于早期禁食组(均P<0.05)。
结直肠癌术后早期口服肠内营养安全有效,是自然的营养途径,可减轻手术相关应激反应,改善术后患者营养状况,加速康复。