目的 探讨家庭肠内营养治疗对食管癌患者微创食管切除术后营养状况的影响。方法 选取2018-11至2019-11在解放军总医院第六医学中心接受微创食管癌切除术的患者81例,随机分为干预组和对照组。其中对照组出院后仅给予普通居家膳食;而干预组在对照组基础上,另经空肠造瘘管泵入肠内营养制剂。在出院1个月后,对比两组患者的营养指标,包括欧洲营养风险筛查2002(NRS2002)得分、身体质量指数(BMI)和血清营养指标等。结果 两组患者术前各项病理生理学和营养指标的基线特征差异无统计学意义,具有可比性(P>0.05)。出院后1个月,欧洲营养风险指标干预组低于对照组,干预组BMI高于对照组,干预组实验室血清营养指标优于对照组,差异均具有统计学意义(P<0.05)。结论 微创食管癌根治术后开展家庭肠内营养治疗,可明显改善患者的营养状况,降低术后营养不良风险。
Abstract
Objective To investigate the effect of home enteral nutrition (HEN) therapy on nutritional status of patients after minimally invasive esophagectomy.Methods In this prospective randomized controlled clinical trial, patients with esophageal cancer who had undergone minimally invasive esophagectomy in our center were selected, and eligible ones were randomly divided into the control group and the intervention group. Patients in the control group were given standard care after discharge from the hospital, while those in the intervention group underwent gastrojejunostomy in which a jejunal nutritional tube was placed and received HEN in addition to standard care after being discharged from the hospital. One month after discharge from the hospital, the nutritional indicators were compared between the two groups, including the European Nutritional Risk Screening 2002 (NRS2002) score, body mass index (BMI), and serum nutrition indicators.Results A total of 81 eligible patients were enrolled between November 2018 and November 2019, with 41 patients in the intervention group and 40 patients in the control group. There was no significant difference in baseline characteristics and nutritional indicators between the two groups before surgery (P>0.05). One month after discharge from the hospital, the NRS2002 score of patients in the intervention group was lower than that of patients in the control group, but BMI was higher, and serum nutrition indicators were better (P<0.05).Conclusions For patients who have undergone minimally invasive esophagectomy, HEN treatment can significantly improve nutritional status, and reduce the risk of postoperative malnutrition.
关键词
家庭肠内营养 /
食管肿瘤 /
微创 /
空肠造瘘
Key words
home enteral nutrition /
esophageal neoplasm /
minimally invasive /
gastrojejunostomy
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基金
解放军总医院第六医学中心护理创新培育基金(HLCX-201910)
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