摘要：目的 观察喉癌术后鼻饲复合全营养素或鼻饲家庭自备流质膳对患者临床结局的影响，了解术后肠内营养支持对喉癌患者的重要意义。方法 回顾性地分析2003年11月至2013年7月入住大坪医院耳鼻喉科行喉癌全切术或次全切术后患者329例，经病理检查均证实为喉癌恶性肿瘤，术后均采用鼻胃管给予营养支持。其中，由大坪医院营养科采用复合全营养素进行肠内营养干预278例（Enternal nutrition group, EN组）, 不愿接受全营养素干预，而采用家庭自备流质膳51例（Convenience diet group, CD组）。通过病历回顾，分析EN组和CD组术后咽瘘、感染、术后放化疗、再次入院率、肠内营养天数、带鼻饲管时间、平均住院日等临床指标，比较两者的营养支持效果。结果 EN组术后咽瘘发生率为4.68%（13/278），CD组术后咽瘘发生率为11.76%（6/51）。EN组咽瘘发生率显著低于CD组，具有统计学意义(P=0.046)；其他临床结局指标两组间无明显差异。结论 喉癌全切或次全切术后，用复合全营养素进行肠内营养支持较家庭自备流质膳可明显降低患者术后咽瘘发生率，有利于患者康复。

Abstract：Objective To evaluate the efficiency of early enteral nutritional support in patients underwent laryngectomy. Methods We retrospectively reviewed and analyzed 329 larynx cancer patients underwent total or partial laryngectomy from November 2003 to July 2013 in Daping Hospital. Of these patients, 278 (EN group) were given enteral nutrition with commercial formulations within 24 hours after the surgery through the nasogastric tube, 51 patients (Convenience diet group， CD group) rejected the enteral nutrition treatment and were on homogenated diet. We compared the rate of fistula formation, post-surgical infection rate, average length of hospitalization, and other clinical indicators between the two groups. Results 13 patients (13/278, 4.68%) in the EN group, and 6 patients (6/51, 11.76%) in the CD group had fistula formation. The difference is found statistically significant (P<0.046). The differences of post-surgical infection rate, average length of hospitalization and other clinical indicators between the two groups are not statistically significant. Conclusions The risk of fistula formation may be shortened in patients underwent laryngectomy by giving early enteral nutrition.