The Observation On The Three Methods Of Postoperative Nutrition Support In Elderly Patients With Esophageal Cance

Background:The incidence rate of esophageal cancer is increasing for every year,elderly patients with esophageal cancer is mostly. In before or after operation,most patients with esophageal carcinoma will suffer from eating disorders,inadequate nutrients intake, malignant cancer cells consuming and so on, whichresults nutritional deficiency. Additionally, there are different inflammatoryesophagus conditions, particularly eldly patients with hypertention, heartdisease, diabetes and other dangerous factors have lower metabolism and localblood supply reduction, which will disorder the nomal digesting and absorbingability of gastrointestinal tract. However, the postoperative energy requirementsof body is2or3times of preoperation. So mixed nutrition support is veryimportant to the patents, which will influence the surgical incision healing,prevention of complication, and body recovery.Objective：To observe the effects of three teem nutritional supports the postoperativeesophageal cancer in elderly patients and to find the best-nutritional supportsfor them。Methods:90elderly patients with esophageal cancer in the NO1hosptioal of JiLinuniversityfrom2010-5to2011-12were divided into three groups randomlybefore operation intestinal nutrition group(EN，n=30),fully parenteral nutritiongroup(PN，n=30) and mixed nutrition group(MN，n=30), Three groups receiveddifferent nutrition support methods respectively. Total Serum Protein, Albuminand White Blood Cells were detected on the1st day preoperative, the7th day postoperative these were compared weth each other in various group.tocompare clinical data of economic consumption and the postoperativelength of hospital stay.The measurement data were analyzed with SPSS11.0softeare。Results：1The age and weight in the three group had no statisticalsignificantly.The weight had all low afere operation but MN group had thelowest,there was no the difference sigificanton on the fourst days afereoperation（P﹥0.05）, but there was more difference sigificanton on thesevernst days afere operation（P﹤0.05）。2there was no significant differencesinthe3groups for total serum protein,albumin.they were all elevated befor operation in all3groups detected on the1st day preoperative（P﹥0.05）, there was no difference on the4th daypostoperative,but the7th day postoperative and the date of discharge. Theinformations about recovery of gastrointestinal function, incidence rate ofpostoperative complications(P﹤0.05）。 but did not return to near thepreoperative baseline。3The white blood cell befor operation in the three group compared that nosigificant difference.theywere all low in the three group,but MN with the whiteblood cell were no sigificant charge. the difference were sigificant on the4thday after operation.(P﹤0.05）。the same result on the7th day after operation.(P﹤0.05）。4The postoperative length of hospital stay compared among the threegroups showed significantly difference, these was that PN=20.6±5.7、EN=25.3±7.4、MN=17.3±3.4（P﹤0.05）,the difference were sigificant.。5The postoperative complication compared among the three groups:PNgroup was associated with complication of disruption for1piece and delayed healing of wounds for two pieces, the overall incidence was10%;EN groupwas anastomosis leakage the complications in control g the overall incidencewas6.66%there was no statistical differences between them,but comparingwith MN and EN group,the difference were sigificant(F=0.036,P﹤0.05）。6The informations about recovery of gastrointestinal function, MNwasthelargest bowel movement.EN=43.8±21.6h；EN=73.1±22.3h；PN=49.5±24.3h（P﹤0.05）,the difference were sigificant。Conclusion：1、MN in the elderly patients with esophageal cance could make theweight to change but it shorten the length hospital stay;2、MN could lower the postoperative complication,it could betterrecovery of gastrointestinal function；3、MN in the the elderly patients with esophageal cance could avoid thenutrition support for samplly,itcould improve nutritional status andsurgicaldisturbanceit will take more sufficient nutrition support for body’s needs.