老年食管癌患者术后不同营养支持方式临床结局的比较

摘要

目的 探讨不同营养支持方式对老年食管癌患者术后临床结局的影响.方法 选择2015年11月至2016年8月绵阳市中心医院胸心外科收治的年龄≥60岁的食道癌患者90例,术前采用随机数字表法分为3组:肠内营养(EN)组,肠外营养(PN)组和EN+PN组,每组30例.术后24h内进行相应的营养支持.观察3组患者体质量亏损、住院时间、住院费用以及肺部感染发生率等指标.采用SPSS 19.0软件进行数据处理.依据数据类型,组间比较分别采用t检验或χ2检验.结果 与EN组相比,PN组患者的体质量亏损显著增加[(7.3±1.3)vs(6.4±1.6)kg],而EN+PN组患者的体质量亏损显著降低[(4.6±1.0)vs(6.4±1.6)kg],差异均具有统计学意义(P<0.05).EN+PN组患者的术后住院时间及肺部感染发生率均显著少于EN组和PN组(P<0.05),而EN组和PN组的术后住院时间及肺部感染发生率差异无统计学意义(P>0.05).3组患者住院费用PN组>EN+PN组>EN组,两两比较差异均有统计学意义(P>0.05).结论 早期肠内联合肠外营养支持对老年食管癌患者术后的临床结局改善效果较好.%Objective To determine the effect of different nutritional supports on the clinical outcomes in elderly patients with esophageal cancer after operation.Methods A total of 90 elderly patients with esophageal cancer undergoing surgical treatment in the Department of Thoracic Surgery of Mianyang Central Hospital from November 2015 to August 2016 were enrolled in this study, and were randomly divided into 3 groups before surgery:enteral nutrition(EN)group,parenteral nutrition(PN)group and enteral nutri-tion combined with parenteral nutrition(EN+PN)group,with 30 cases in each group.All patients were given the corresponding nutri-tional supports within 24 h after operation.Clinical outcomes were evaluated with body weight loss,length of hospital stay,hospitaliza-tion costs,and incidence of pulmonary infection.SPSS statistics 19.0 was used to analyze the date.Student's t test or Chi-square test was adopted to make the comparison between groups.Results Compared with the patients of EN group,the body mass loss was higher in those of the PN group[(7.3 ±1.3)vs(6.4 ±1.6)kg],but lower in those of the EN +PN group[(4.6 ±1.0)vs(6.4 ±1.6)kg, both P<0.05].The EN+PN group had notably shorter length of hospital stay and lower incidence of pulmonary infection than the EN and PN groups(P<0.05),while there were no significant differences between the latter 2 groups(P>0.05).The hospitalization cost was the highest in the PN group, followed by the EN +PN group and the EN group in turn, with obvious difference between mutual groups(P<0.05).Conclusion Early nutritional support with EN +PN is better than others in terms of improving clinical outcomes of the elderly patients with esophageal cancer after surgery.