直肠癌Dixon术后早期肠内外联合营养的临床研究

为了探讨直肠癌患者行直肠癌经腹前切除术（Dixon术）后早期肠内营养（EN）与肠外营养（PN）联合应用的临床价值，将64例行Dixon术的直肠癌患者随机分为肠外营养组（PN组）32例和肠内外联合营养组（EN＋PN组）32例。术后早期即给予不同的营养支持治疗，观察患者术后肛门排气时间、术后并发症发生情况及营养指标的变化。结果显示，两组患者均无死亡病例，均未发生吻合口漏，EN＋PN组在术后肛门排气时间等方面明显优于PN组；术后第7天检测各项营养指标，EN＋PN组前白蛋白（PA）、淋巴细胞总数（TLC）高于PN组（P〈0．05）。结果表明，直肠癌Dixon术后早期肠内外联合营养是安全可行的，不但能更好地改善术后患者营养状况及免疫功能，还能促进肠蠕动功能的恢复，并且能降低切口并发症的发生率。

Clinical Study of Early Combined Enteral and Parenteral Nutrition in Rectal Cancer after Dixon Operation

This study was to discuss the clinical value of early combined enteral nutrition（EN） and paren- teral nutrition（PN） in rectal cancer after Dixon operation. The 64 cases of this disease were randomly di- vided into PN group and EN~-PN group,32 cases for each. Different early postoperative nutritional support was given to these patients, who were observed for postoperative complications, time for flatus and nutri- tional indicators. The results showed that there was no death case, no anastomotic leakage of both groups. EN-~PN group was superior to PN group in time for flatus. Seven days after surgery,nutrition indicators such as pre- albumin （PA） and total lymphocyte count（TLC） were higher in ENq-PN group than in PN group（ P d0.05）. It is concluded that early combined enteral and parenteral nutrition in rectal cancer after Dixon operation is safe and feasible, for it can better improve the nutrition status and immune function, pro- mote the recovery of bowel peristalses function, and reduce the incidence of wound complications.