Dai L, Fu H, Kang X Z, Yang Y B, Zhou H T, Liang Z, Xiong H C, Lin Y, Chen K N
First Department of Thoracic Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.
Zhonghua Wai Ke Za Zhi. 2018 Aug 1;56(8):607-610. doi: 10.3760/cma.j.issn.0529-5815.2018.08.011.
To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (=56) and traditional tube feeding group (=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ(2) test, Fisher exact test and test, respectively. Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ(2)=2.393, =0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (=7.720, =0.000); the general enteral complications were significantly lower (26/52 . 5/56, χ(2)=22.225, =0.000), the nutritional support complete rate was significantly higher (23/52 . 55/56, χ(2)=39.167, =0.000). Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.
探讨食管癌切除术后家庭肠内营养持续泵入的效果及安全性。本研究回顾性分析了2017年1月至2017年11月在北京大学肿瘤医院暨北京市肿瘤防治研究所胸外科一病区接受经胸食管癌切除术的食管癌患者。共108例,其中男性88例,女性20例,平均年龄62岁。将患者分为泵饲组(n = 56)和传统管饲组(n = 52)。分别采用χ²检验、Fisher确切概率法和t检验比较两组术后短期安全性、体重维持情况、肠内营养耐受性及营养支持完成率。与传统管饲组相比,泵饲组患者安全性明显更好,出院后2个月内并发症分别为11/52和4/56(χ² = 2.393,P = 0.035);体重维持情况明显更好,出院后4周内体重下降分别为3.90 kg和0.13 kg(t = 7.720,P = 0.000);总体肠内并发症明显更低(26/52对5/56,χ² = 22.225,P = 0.000),营养支持完成率明显更高(23/52对55/56,χ² = 39.167,P = 0.000)。术后出院后持续泵入肠内营养支持有助于提高患者出院后的安全性,更有利于患者体重维持。泵饲还可提高管饲耐受性,确保营养支持有效完成。