摘要：目的采用肠内营养对结肠癌患者术后进行营养治疗。方法71例住院结肠癌患者，平均年龄52．53±13．94岁，随机分为肠内营养治疗组(EN)和静脉营养治疗组(PN)。每天基础热能按125kJ(30Kcal)／kg体重，蛋白质1．25g／kg(0．2g氮／kg)，热氮比值为非蛋白热能150Kcal：1g氮。结果EN组未见有恶心、呕吐、腹胀、腹泻等胃肠反应。全部患者的外部切口均Ⅰ期愈合。术前EN组47．06％，PN组48．47％的患者存在营养不良。体重、握力、MAC、MAMC、TSF、淋巴细胞总数、Hb、TP、A、BUN、CR、Na、K、Cl、血糖、Tch、TG等指标均在正常范围内。两组均为负氮平衡，术后第3d与第9d相比，差异均有显著性(P＜0．05)。EN组血清谷氨酰胺和谷氨酸高于PN组，差异有显著性(P＜0．05)，其余氨基酸无差异。PN组尿L／M值升高，与EN组相比，差异有显著性(P＜0．05)。结论结肠癌患者术后用肠内营养治疗有明显的效果并能维护肠屏障功能。

Therapeutic effects of enteral nutrition in patients with colon cancer receiving coloproctostomy

cAI Donglian,HU Tongjic,ZHU Liping(Department of Nutritology, Changhai Hospital, SMMU Center of Clinical Nutrtiology, PLA, Shanghai 200433)

Abstract：Objective Patients with canncer after coloproctostomy were giving the nutritional therapy using Nutren as a whole nutritents products. Methods Cases of 71 with colon cancer were rendomizedly divided into enteral nutrition group (EN) and parenteral nutrition group(PN), average age 52.53 ± 13.04yr. They were given the basic energy 125kJ(30Kcal), protein 1.25g(0.2gN) per kg body weight/kg per day, and non-protein energy nitrogen ratio as 150kcal: 1gN. Results There were no gut reactions in EN group such as nausea, vomit, abdoment bulge, diarrhea etc during the trial. The incision in all stdferes were healed up I phase. Before operation malnutritionin EN and PN group were existed as 47.06 % and 48.47 %, respectively. There were no diference between before operatuion from after operation in EN and PN groups, such as body weight, grip, MAC, mAMC, TSF, TLC, Hb, TP, A, BUN, CR, Na, K, C1, blood sugar, serum Tch and TG. There were difference at the negative nitrogen balance after operation between 3rd from 9th days in both groups (P ＜ 0.05). The serum concentrations of glutamine in EN group were higher than that of PN group (P ＜ 0.05 ). The urine L/M ratio in PN group was greatly increased. Conclusions Enteral nutrition can be an effectively therapy for patiennts after cooproctostomy.