石海燕　　陈宏林　　吴超　　冯素娟

[摘要] 目的 研究口服營养补充（ONS）对食管癌根治术后出院患者营养状况的影响。 方法 选择2018年1至12月在如皋市人民医院胸外科行食管癌根治术的患者68例，随机分为对照组和实验组，对照组给予常规经口进食，实验组在对照组的基础上，将上下午的加餐改为口服营养补充剂，供能500kcal/d。对比1个月后两组患者的体重变化率、PG-SGA评分和相关实验室营养指标差异。 结果 实验组患者出院后1个月体重变化率为正值且明显高于对照组[（-4.35±4.69）vs（2.65±3.21）]，PG-SGA评分[（6.5±2.9）vs（5.0±2.3）]、血清总蛋白[（61.4±3.1）vs（63.9±4.0）]、血清白蛋白[（36.3±3.7）vs（38.5±2.7）]、前白蛋白[（173.2±30.0）vs（196.5±33.6）]各参数间比较，差异有统计学意义（P<0.05）。 结论 对食管癌根治术后出院患者实施口服营养补充，能够增加患者的体重、改善其营养指标以及降低其营养不良的风险，是一种方便、有效的营养干预方法。

[关键词] 口服营养补充;食管癌根治术;出院患者;营养状况

[中图分类号] R735.1          [文献标识码] B          [文章编号] 1673-9701（2021）11-0176-04

The effect of oral nutritional supplementation on the nutritional status of discharged patients after radical resection of esophageal cancer

SHI Haiyan1， 2   CHEN Honglin3   WU Chao1   FENG Sujuan1

1.Department of Cardiothoracic Surgery， Rugao Municipal People′s Hospital， Rugao   226500， China; 2.Medical School of Nantong University， Nantong   226019， China; 3.School of Public Health， Nantong University， Nantong   226019， China

[Abstract] Objective To study the effect of oral nutritional supplement（ONS） on the nutritional status of discharged patients after radical esophageal cancer surgery. Methods A total of 68 patients who underwent radical esophageal cancer surgery in the Thoracic Surgery Department of Rugao People's Hospital from January 2018 to December 2018 were selected and randomly divided into the control group and the experimental group. The control group was given regular oral feeding， and the experimental group was given oral nutritional supplements instead of snacks in the morning and afternoon based on the nutrition of the control group. The energy supply was 500 kcal/d. The differences in weight change rate， PG-SGA score and related laboratory nutrition indicators between the two groups were compared after one month. Results The weight change rate of patients in the experimental group was positive one month after discharge， which was significantly higher than that of the control group [（-4.35±4.69） vs （2.65±3.21）]. There were significant differences in PG-SGA score [（6.5±2.9）vs（5.0±2.3）]， total serum protein [（61.4±3.1）vs（63.9±4.0）]， serum albumin[（36.3±3.7）vs（38.5±2.7）] and prealbumin[（173.2±30.0）vs（196.5 ±33.6）] between the two groups （P<0.05）. Conclusion Oral nutritional supplementation for patients discharged from the hospital after radical esophageal cancer surgery can increase the weight of patients， improve their nutritional indicators and reduce their risk of malnutrition. It is a convenient and effective nutritional intervention method.

[Key words] Oral nutritional supplementation; Radical resection of esophageal cancer; Discharged patients; Nutritional status

食管癌是常见的消化道恶性肿瘤之一，手术切除病变食管并重建消化道是早中期食管癌患者首选的治疗方案[1]。由于消化道的重建及手术创伤的应激，食管癌手术后患者的营养不良发生率高达60%～85%[2]，主要表现为体重下降及低蛋白血症[3-4]，二者已被证明是肿瘤患者不良预后的危险因素[5-7]。食管癌手术患者出院后的营养风险发生率高于住院期间[8]，其原因与患者出院后的饮食营养及能量无法量化有关[9]，故而探索经济方便、合理有效的营养干预措施非常重要。口服营养补充（oral nutritional supplements，ONS）是指“除了正常食物外，经口摄入特殊医学用途（配方）食品以补充日常饮食的不足”[10]。本研究旨在探讨口服营养补充对食管癌根治术后出院患者营养状况的改善效果，现报道如下。……