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糖尿病合并食管癌患者术后早期经口进食的安全性分析

Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes.

作者信息

Jiang Zhisheng, Luo Jing, Xu Mengqing, Cong Zhuangzhuang, Ji Saiguang, Diao Yifei, Xu Yang, Shen Yi

机构信息

Bengbu Medical College, Bengbu, China.

Department of Cardiothoracic Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing, China.

出版信息

J Cardiothorac Surg. 2021 Mar 26;16(1):56. doi: 10.1186/s13019-021-01410-4.

DOI:10.1186/s13019-021-01410-4
PMID:33771195
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7995741/
Abstract

OBJECTIVE

To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.

METHODS

The clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups.

RESULTS

There was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05).

CONCLUSIONS

Early oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.

摘要

目的

评估Ⅱ型糖尿病患者食管癌根治术后早期经口进食的安全性。

方法

回顾性分析2016年1月至2018年12月在金陵医院胸心外科行食管癌根治术的121例Ⅱ型糖尿病患者的临床资料。根据术后首次经口进食的中位时间(7天),将患者分为早期经口进食组(EOF,术后7天内进食,67例)和晚期经口进食组(LOF,术后7天后进食,54例)。记录并比较两组患者术后血糖水平、并发症发生率、营养和免疫指标、炎症指标、T12-SMA归一化值(第12胸椎水平竖脊肌横截面积的术后/术前比值)和QLQ-C30(生活质量问卷)评分。

结果

EOF组和LOF组术前营养指标和术后并发症发生率差异无统计学意义(p>0.05)。EOF组术后营养指标(ALB、PA、TRF、Hb)和免疫指标(IgA、IgG、IgM)高于LOF组(p<0.05),EOF组炎症指标(CRP、IL-6)显著低于LOF组(p<0.05)。此外,EOF组术后T12-SMA变化和QLQ-C30评分高于LOF组(p<0.05)。

结论

早期经口进食对Ⅱ型糖尿病患者食管癌根治术后是安全可行的,可改善患者短期营养状况和术后生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/7995741/c71b52e4137e/13019_2021_1410_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/7995741/220075f79540/13019_2021_1410_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/7995741/c71b52e4137e/13019_2021_1410_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/7995741/220075f79540/13019_2021_1410_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/7995741/c71b52e4137e/13019_2021_1410_Fig2_HTML.jpg

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