Clinical evaluation of early enteral nutrition in the treatment of advanced esophageal cancer / 中国综合临床

ABSTRACT

Objective To investigate the impact of early enteral nutrition on the nutritional status and complications of patients with advanced esophageal carcinomas.Methods Sixty-five patients with advanced esophageal carcinomas were randomly divided into the enteral nutrition group group (n =33) and the control group (n =32).The two groups were given enteral nutrition support and normal nasogastric feeding diet respectively in 24-72 h after hospitalization.The two groups were tested with nutrition indicatorsbody Mass Index (BMI)/brachial triceps skinfold thickness/upper arm circumference measurement,fasting blood glucose/serum total protein/albumin/cholesterol/triglyceride and the liver function (alanine aminotransferase (ALT)/aspartate aminotransferase(AST)/total bilirubin (TBiL)),and were observed the incidences of complications with liver/intestinal and infection diseases.Results After one month's treatment,compared with the control group,there was significant statistical difference between the two group in patients' nutritional status (BMI index(22.1 ±4.5) kg/m2 vs.(19.2±4.3) kg/m2; skinfold thickness(6.2 ±0.4) mm vs.(5.1 ±0.4)mm ; upper arm circumference(22.8 ± 3.0) cm vs.(20.4 ± 3.2) cm ; serum total protein(49.2 ± 10.1) g/L vs.(45.1 ± 9.9) g/L; Albumin(35.5 ± 5.8) g/L vs.(30.6 ± 6.1) g/L; Cholesterol(5.0 ± 0.6) mmol/L)vs.(4.3 ± 0.7) mmol/L)),the liver function(ALT(36.0 ± 4.7) U/L vs.(61.5 ± 9.9) U/L; AST(29.6 ±6.7) U/Lvs.(88.9±10.6) U/L;TBiL(17.7±3.8) μmol/Lvs.(31.6 ±9.4) μmol/L) (t=2.624,2.036,2.220,2.256,4.155,2.207,2.349,2.476,2.280 respectively,P ＜ 0.05 for all),and the incidence of diarrhea (12％ (4/33) vs.34％ (11/32)) and infection (15％ (5/33) vs.41％ (13/32)) (x2 =2.501,2.193 respectively;P ＜0.05).No statistical difference was observed between the two groups on the levels of serum glucose and triglycerides,and the incidences of complications like bloating/constipation/reflux (P ＞ 0.05).Conclusion The early enteral nutrition could improve the nutritional status of patients with advanced esophageal carcinomas effectively,and reduce the incidence of liver injury,diarrhea and infection.