周寅 1,2 , 楊廷翰 1,2 , 汪曉東 2,3 , 李立 2,3
  • 1.四川大學(xué)華西臨床醫(yī)學(xué)院/華西醫(yī)院（成都 610041）;;
  • 2.四川大學(xué)華西醫(yī)院MCQ團(tuán)隊(duì)（成都 610041）;;
  • 3.四川大學(xué)華西醫(yī)院胃腸外科中心（成都 610041）;

目的 探討結(jié)直腸癌術(shù)后早期經(jīng)口進(jìn)食的可行性、安全性及術(shù)后早期康復(fù)情況。
方法 回顧性分析2008 年1～6月期間，四川大學(xué)華西醫(yī)院胃腸外科中心結(jié)直腸外科專(zhuān)業(yè)組收治的128例結(jié)直腸癌患者的臨床資料，56 例為早期經(jīng)口進(jìn)食（early oral feeding，EOF）組，72 例為傳統(tǒng)進(jìn)食（traditional feeding，TF）組。比較2組病例術(shù)后住院時(shí)間，術(shù)后首次排氣和排便時(shí)間，以及胃潴留、腸梗阻、重度腹瀉、肺部感染、傷口感染、吻合口漏等并發(fā)癥發(fā)生率。
結(jié)果 EOF組術(shù)后住院時(shí)間，術(shù)后首次排氣、排便時(shí)間均短于TF組，差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05）； EOF組胃潴留發(fā)生率高于TF組，差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05），而2組腸梗阻、重度腹瀉、肺部感染、傷口感染及吻合口漏的發(fā)生率差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。早期經(jīng)口進(jìn)食耐受率可達(dá)89.29%（50/56）。
結(jié)論 結(jié)直腸癌術(shù)后行早期經(jīng)口進(jìn)食是安全、可行的，能促進(jìn)患者的早期康復(fù)。

引用本文： 周寅,楊廷翰,汪曉東,李立. 早期經(jīng)口進(jìn)食在結(jié)直腸癌術(shù)后快速流程模式中的應(yīng)用. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(5): 500-503. doi: 復(fù)制

1. Wille-Jrgensen P, Guenaga KF, Castro AA, et al. Clinical value of preoperative mechanical bowel cleansing in elective colorectal surgery: a systematic review [J]. Dis Colon Rectum, 2003; 46(8): 1013-1020.
2. Ng WQ, Neill J. Evidence for early oral feeding of patients after electiveopen colorectal surgery: a literature review [J]. J Clin Nurs, 2006; 15(6): 696-709.
3. Kehlet H. Fast-track colorectal surgery [J]. Lancet, 2008; 371(9615): 791-793.
4. 劉展， 汪曉東， 李立. 結(jié)直腸外科快速流程內(nèi)容及依據(jù) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2007； 14(4): 469-473.
5. Basse L, Billesblle P, Kehlet H, et al. Early recovery after abdominal rectopexy with multimodal rehabilitation [J]. Dis Colon Rectum, 2002; 45(2): 195-199.
6. Langelotz C, Spies C, Müller JM, et al. “Fast-track” rehabilitation in surgery, a multimodal concept [J]. Acta Chir Belg, 2005; 105(6): 555-559.
7. Reynolds JV, Kanwar S, Welsh FK, et al. Dose the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? [J]. JPEN, 1997; 21(4): 196-201.
8. Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy[J]. Ann Surg, 1997; 226(4): 577-580.
9. Feo CV, Lanzara S, Sortini D, et al. Fast track postoperative management after elective colorectal surgery: a controlled trail [J]. Am Surg, 2009; 75(12): 1247-1251.
10. Camberos A, Cymerman J, DiFronzo LA, et al. The effect of cisapride on the success of early feeding after elective open colon resection [J]. Am Surg, 2002; 68(12): 1093-1096.
11. Petrelli NJ, Cheng C, Driscoll D, et al. Early postoperative oral feeding after colectomy: an analysis of factors that may predict failure [J]. Ann Surg Oncol, 2001; 8(10): 796-800.
12. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials [J]. BMJ, 2001; 323(7316): 773-776.
13. Buchmann P, Bischofberger U, De Lorenzi D, et al. Early postoperative nutrition after laparoscopic and open colorectal resection [J]. Swiss Surg, 1998; 4(3): 146-155.
14. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus [J]. World J Surg, 2006; 30(8): 1382-1391.
15. Reissman P, Teoh TA, Cohen SM, et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial [J]. Ann Surg, 1995; 222(1): 73-77.
16. Correia MI, da Silva RG. The impact of early nutrition on metabolic response and postoperative ileus [J]. Curr Opin Clin Nutr Metab Care, 2004; 7(5): 577-583.
17. Repin VN, Tkachenko IM, Gudkov OS, et al. Enteral tube feeding early after surgery on the stomach and the Duodenum [J]. Khirurgiia (MOSK), 2002; (12): 21-25.
18. Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis [J]. World J Surg, 2005; 29(8): 1023-1027.
19. Bisgaard T, Kehlet H. Early oral feeding after elective abdominal surgery-what are the issues? [J]. Nutrition, 2002; 18(11-12): 944-948.
20. Henriksen MG, Hansen HV, Hessov I. Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization [J]. Nutrition, 2002; 18(3): 263-267.
21. Henriksen MG, Jensen MB, Hansen HV, et al. Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery [J]. Nutrition, 2002;18(2): 147-152.
22. Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus [J]. Arch Surg, 2003; 138(2): 206-214.
23. Villalba Ferrer F, Bruna Esteban M, García Coret MJ, et al. Evidence of early oral feeding in colorectal surgery [J]. Rev Esp Enferm Dig, 2007; 99(12): 709-713.
  1. 1. Wille-Jrgensen P, Guenaga KF, Castro AA, et al. Clinical value of preoperative mechanical bowel cleansing in elective colorectal surgery: a systematic review [J]. Dis Colon Rectum, 2003; 46(8): 1013-1020.
  2. 2. Ng WQ, Neill J. Evidence for early oral feeding of patients after electiveopen colorectal surgery: a literature review [J]. J Clin Nurs, 2006; 15(6): 696-709.
  3. 3. Kehlet H. Fast-track colorectal surgery [J]. Lancet, 2008; 371(9615): 791-793.
  4. 4. 劉展， 汪曉東， 李立. 結(jié)直腸外科快速流程內(nèi)容及依據(jù) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2007； 14(4): 469-473.
  5. 5. Basse L, Billesblle P, Kehlet H, et al. Early recovery after abdominal rectopexy with multimodal rehabilitation [J]. Dis Colon Rectum, 2002; 45(2): 195-199.
  6. 6. Langelotz C, Spies C, Müller JM, et al. “Fast-track” rehabilitation in surgery, a multimodal concept [J]. Acta Chir Belg, 2005; 105(6): 555-559.
  7. 7. Reynolds JV, Kanwar S, Welsh FK, et al. Dose the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? [J]. JPEN, 1997; 21(4): 196-201.
  8. 8. Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy[J]. Ann Surg, 1997; 226(4): 577-580.
  9. 9. Feo CV, Lanzara S, Sortini D, et al. Fast track postoperative management after elective colorectal surgery: a controlled trail [J]. Am Surg, 2009; 75(12): 1247-1251.
  10. 10. Camberos A, Cymerman J, DiFronzo LA, et al. The effect of cisapride on the success of early feeding after elective open colon resection [J]. Am Surg, 2002; 68(12): 1093-1096.
  11. 11. Petrelli NJ, Cheng C, Driscoll D, et al. Early postoperative oral feeding after colectomy: an analysis of factors that may predict failure [J]. Ann Surg Oncol, 2001; 8(10): 796-800.
  12. 12. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials [J]. BMJ, 2001; 323(7316): 773-776.
  13. 13. Buchmann P, Bischofberger U, De Lorenzi D, et al. Early postoperative nutrition after laparoscopic and open colorectal resection [J]. Swiss Surg, 1998; 4(3): 146-155.
  14. 14. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus [J]. World J Surg, 2006; 30(8): 1382-1391.
  15. 15. Reissman P, Teoh TA, Cohen SM, et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial [J]. Ann Surg, 1995; 222(1): 73-77.
  16. 16. Correia MI, da Silva RG. The impact of early nutrition on metabolic response and postoperative ileus [J]. Curr Opin Clin Nutr Metab Care, 2004; 7(5): 577-583.
  17. 17. Repin VN, Tkachenko IM, Gudkov OS, et al. Enteral tube feeding early after surgery on the stomach and the Duodenum [J]. Khirurgiia (MOSK), 2002; (12): 21-25.
  18. 18. Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis [J]. World J Surg, 2005; 29(8): 1023-1027.
  19. 19. Bisgaard T, Kehlet H. Early oral feeding after elective abdominal surgery-what are the issues? [J]. Nutrition, 2002; 18(11-12): 944-948.
  20. 20. Henriksen MG, Hansen HV, Hessov I. Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization [J]. Nutrition, 2002; 18(3): 263-267.
  21. 21. Henriksen MG, Jensen MB, Hansen HV, et al. Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery [J]. Nutrition, 2002;18(2): 147-152.
  22. 22. Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus [J]. Arch Surg, 2003; 138(2): 206-214.
  23. 23. Villalba Ferrer F, Bruna Esteban M, García Coret MJ, et al. Evidence of early oral feeding in colorectal surgery [J]. Rev Esp Enferm Dig, 2007; 99(12): 709-713.