目的  大多数营养不良的消化道恶性肿瘤患者术前、术后禁食使机体营养不良加重，机体免疫力下降，感染发生 率、死亡率明显上升。本文探究围手术期 EN 对食管癌患者术后转归的影响。方法  采用前瞻性随机对照研究，将我院接受 手术的食管癌患者随机分为EN 组和PN 组，前者完成40 例，后者完成39 例。EN 组患者从术前5 天开始，在正常饮食基 础上加服肠内营养（瑞能）600ml/d，术后 24小时内开始经空肠营养管或鼻肠管滴注肠内营养液。 PN组患者术前5天开始， 在正常饮食基础上加用PN（能量为750kcal/d），术后常规静脉营养治疗。观察两组患者外周血淋巴细胞计数、血清白蛋 白变化，肛门排气恢复时间和排便恢复时间，感染、吻合口瘘发生例数，心血管事件发生例数。结果  EN 组肛门排气恢复 时间和排便恢复时间比 PN 组早，差异有统计学意义（P ＜ 0.05）。手术前后 EN 组的淋巴细胞计数、血清白蛋白计数降低 值比PN 组小，差异有统计学意义（P ＜ 0.05）。EN 组术后感染、吻合口瘘发生例数比PN 组少，但腹胀发生例数多。结 论  围手术期 EN 优于 PN，对食管癌患者术后转归有积极影响，值得推广，也是快速康复外科理念的重要部分。

Objective In most cases, preoperative and postoperative fasting can aggravate the nutritional status and body immunity, and increase the incidence of infection and mortality rate of patients with alimentary tract malignant tumor. The objective of this study is to investigate the effects of perioperative enteral nutrition on the prognosis of patients with esophageal cancer after operation. Methods A prospective randomized controlled clinical study was designed. The patients with esophageal cancer who underwent operation in our hospital were randomly divided into enteral nutrition group and total parenteral nutrition group. 40 cases were carried out in EN group, and 39 cases in PN group. In EN group, enteral nutrition solution 600ml/d were added from 5 days before operation, based on normal diet, and they were given enteral nutrition within 24h after operation. In PN group, parenteral nutrition (750kcal/d) were added from 5 days before operation, based on normal diet, and were given intravenous nutrition after operation. The changes of peripheral blood lymphocyte count, serum albumin, anal exhaust recovery time and defecation recovery time, infection, anastomotic leakage and cardiovascular events were observed in the two groups. Results The average time for anal exhaust recovery and defecation recovery in EN group was shorter than PN group with statistical difference (P<0.05). Before and after operation, the lymphocyte count, serum albumin count in EN group was lower than PN group with statistical difference (P<0.05). Postoperative infection and anastomotic fistula in EN group was less than in PN group, but more cases of abdominal distension. Conclusions EN is superior to PN, and it has a positive impact on the prognosis of patients with esophageal cancer in postoperative period. It is worth promoting as an important part of fast track surgery.