目的 探讨早期肠内、外联合营养对食管癌术后的疗效。方法 随机选取我院胸外一科2016-04至2017-04收治的食管癌183例,将患者按照是否进行早期肠内、外联合营养分成两组,其中受试组91例和对照组92例。对受试组患者进行早期肠内、外联合营养,对照组常规肠外营养至7 d后逐渐恢复饮食。分别在术前、术后3 d、术后7 d应用欧洲营养风险筛查量表(nutritionalrisk screening 2002,NRS2002)、CHristensens 法测评疲劳指数、前白蛋白、血浆白蛋白、血红蛋白评估临床疗效。结果 两组患者营养风险筛查量表、疲劳指数及营养状况对比受试组与对照组临床疗效,术后3 d、7 d检测发现,受试组的营养风险评估分数小于3分患者分别为24例(26.37%)、35例(38.46%),均多于对照组22例(23.91%)、24例(26.09%); 在手术后3 d及7 d,受试组的疲劳指数(6.21±0.37、3.37±0.63)均低于对照组(7.36±0.52、6.81±0.29),差异有统计学意义(P<0.05);在术后7 d,受试组前白蛋白、血浆白蛋白平均值分别均高于对照组,差异有统计学意义(P<0.05)。结论 早期肠内、外营养可降低患者的营养风险指数和降低食管癌术后的疲劳指数。值得进一步改善及推广。

Objective To study the effect of early enteral nutrition combined with parenteral nutrition on patients who have received esophageal cancer surgery.Methods One hundred and eighty-three patients with esophageal cancer treated in the First Department of Thoracic Surgery between April 2016 and April 2017 were randomly selected as subjects. They were divided into the study group (n=91) and control group (n=92).The study group was subjected to a combination of enteral and parenteral nutrition while the control group was given parenteral nutrition for seven days before they resumed normal diet.Three days before surgery, three days and one week after surgery, the European nutritional risk screening scale (Nutritional risk screening 2002, NRS2002) and CHristensens method were used to evaluate fatigue indexes and levels of prealbumin, plasma albumin and hemoglobin, respectively.Results Three days and one week after surgery, the number of patients with a nutritional risk assessment score less than 3 points was 24 (38.46%) and 35(26.37%) respectively, larger than 22 (26.09%) and 24 (23.91%)of the control group,so the difference was statistically significant (P<0.05). At 3d and 7d after surgery, the fatigue indexes in the study group were respectively(6.21±0.37、3.37±0.63),compared to(7.36±0.52、6.81±0.29)in the control group. At 7d after surgery, the average levels of prealbumin and plasma albumin were higher than in the control group, and the difference was statistically significant (P<0.05).Conclusions Early enteral and parenteral nutrition can reduce the nutritional risk indexes and fatigue indexes of patients with esophageal cancer.