The Study Of Early Application Of Small Dosage Enteral Nutrition On Postoperative Patients With Colorectal Carcinoma

Objectives:To study the clinical feasibility,safety and effect of early application of small dosage enteral nutrition on postoperative patients with colorectal carcinoma.Methods:fifty cases of colorectal carcinoma were randomly divided into two groups: the enteral nutrition(EN) group (n=26)and parenteral nutrition(PN) group(n=24). All of the patients were given supportive nutrition treatment for 7 days after operation. The total energy taken was calculated by Harris-Benedict formula.The nose intestine tube group(n=20)and the jejunostic tube group(n=6) received the enteral nutrition(Nutrison Fibre) enterally. A series of parameters including lymphocyte count(LC),plasma total protein(TP),albumin(Alb),prealbumin(Pa),retinol binding protein(RBP),alanine aminotrans- ferase (ALT) and total bilirubin (TBil) were assessed before and after operation. The recovery of bowel movement and other digestive symptoms such as abdominal pain, distention, diarrhea, nausea and vomiting were observed during the period of study.Results:there is no death case ,no vomiting case.9 cases(34.61%) happened distension,6 cases(23.08%) happened nausea and distension,3 cas- es(11.53%) could be relieved by gastrointestinal decompression in EN group. the parameters of PT,Alb,and ALT showed no apparent difference between the two groups;The level of TBil was lower in EN group than PN group. When compared with PN group, prealbumin,RBP and LC in EN group increased significant- ly(P<0.05)。The gastrointestinal functions resumed much earlier in EN group (54.6±5.3h)than PN group(74.3±6.7h). ConclusionMost patients can be tolerated after 12h beginning of enteral nutrition, probably because small dose of early enteral nutrition,a local nutrition can stimulate intestinal epithelial cells growth, to promote gastrointestinal hormone secretion and effectively promote gastrointestinal tract functional recovery.After EN group to the full application,the level of LC, Pa and RBP was significantly increased over PN group, suggesting that small dose of early enteral nutrition can improve patient protein metabolism, and promote its synthesis, thereby improving the nutritional status of patients body. In this study, TBil of EN group was less than that of PN group, suggesting that the role of EN reduce cholestasis better than PN. Conclusion: In summary, a small dose of early EN corresponds more physiol- ogical state than PN,can induce gastrointestinal positive feedback effect, and promote gastric peristalsis, cholecystokinin, and stimu- late the digestive juice ,gastrointestinal hormone secretion. EN can increase blood flow in gastrointestinal tract and improve microcir- culation state, and promote anastomotic healing. Early application of small dosage EN is safe and effective ,and will be the preferable supportive nutrition treatment after colorectalectomy.