食管癌术后早期肠内营养耐受与吻合口瘘的相关性探究

Correlation between early enteral nutrition tolerance and anastomotic leakage after esophageal cancer surgery

  • 摘要:
      目的  探讨食管癌术后患者肠内营养耐受与发生吻合口瘘的相关性。
      方法  回顾性收集医院2017年7月—2021年5月收治的149例行食管癌根治术患者的临床资料,根据术后是否发生食管吻合口瘘分为有吻合口瘘组(n=19)和无吻合口瘘组(n=130)。比较2组临床症状发生情况,分析食管癌术后患者肠内营养耐受与发生吻合口瘘的相关性。
      结果  食管癌术后患者吻合口瘘总发生率为12.75%(19/149)。术后喂养不耐受患者的吻合口瘘发生率为32.08%(17/53),高于耐受患者的2.08%(2/96),差异有统计学意义(P<0.05)。有吻合口瘘患者腹胀、反流发生率高于无吻合口瘘患者,差异有统计学意义(P<0.05)。有吻合口瘘组患者的住院时间长于无吻合口瘘组,住院费用高于无吻合口瘘组,差异有统计学意义(P<0.001)。
      结论  食管癌术后吻合口瘘发生率高,术后肠内营养不耐受的患者易导致吻合口瘘不良结局的发生,要避免患者腹内压过高和严重反流情况的发生。护理人员需评估患者肠内营养的耐受性,针对高危患者制订有效的干预措施,以提高患者肠内营养耐受性。

     

    Abstract:
      Objective  To explore the correlation between enteral nutrition tolerance and anastomotic leakage in patients with esophageal cancer after surgery.
      Methods  Clinical data of 149 patients undergoing radical resection of esophageal cancer admitted to our hospital from July 2017 to May 2021 was retrospectively collected. According to whether esophageal anastomotic leakage occurred after surgery, the patients were divided into anastomotic leakage group (n=19) and non-anastomotic leakage group (n=130). The clinical symptoms of the two groups were compared, and the correlation between enteral nutritional tolerance and anastomotic leakage after esophageal cancer was analyzed.
      Results  The total incidence of anastomotic leakage after esophageal cancer was 12.75% (19/149). The incidence of anastomotic leakage in patients with postoperative gastrointestinal intolerance for feeding was 32.08% (17/53), which was significantly higher than 2.08% (2/96) in patients with tolerance for feeding (P < 0.05). The incidence of abdominal distention and reflux in patients with anastomotic leakage was significantly higher than that in patients without anastomotic fistula (P < 0.05). The duration of hospitalization in the anastomotic leakage group was significantly longer than that in the non-anastomotic leakage group, and hospitalization cost was significantly higher than that in the non-anastomotic leakage group (P < 0.001).
      Conclusion  The incidence of anastomotic leakage after esophageal cancer surgery is high, and patients with postoperative enteral nutrition intolerance are prone to occur occurrence of anastomotic leakage, so it is necessary to avoid the occurrence of high abdominal pressure and severe reflux in patients. Nursing staff should evaluate the tolerance of enteral nutrition in patients and formulate effective interventions for high-risk patients to improve the tolerance of enteral nutrition.

     

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