目的 通过回顾性研究调查食管癌术后接受肠内营养的患者以评估早期肠内营养和延迟肠内营养的有效性，由 此来确定最合适开始肠内营养的时间。方法   收集2013 年 1 月至 2014 年 10 月在山东省立医院接受食管切除术的食管癌患 者 208 例，根据患者开始接受肠内营养的时间，将接受术后肠内营养治疗的食管癌患者分为3 组，小于48 小时记为组1， 48~72 小时记为组2，大于72 小时记为组3。记录手术前后患者的各类数据，包括一般资料（年龄、性别、肿瘤分期、病 理类型、手术部位、手术时间及术中失血量）和结局指标（术后并发症时间、住院时间、首次排便时间、住院费用、血清 白蛋白、总蛋白和淋巴细胞水平）。统计学分析采用t 检验、u 检验和卡方检验，检验水准为P ＜ 0.05。结果  在3 组比较 后发现，组1 的胸部引流血量最少、首次排便时间最早、住院时间及住院费用最少，组3 的肺炎发生率在3 组中最高（P= 0.019）。组 3 中与营养状况相关的白蛋白、总蛋白及淋巴细胞水平最低，与组1、组2 相比差异均具有统计学意义。结论   食管癌术后 48 小时内开始早期肠内营养对患者是安全有效的。

Objective We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. Methods A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (group 1, 2 and 3) based on whether they received EN within 48 h, 48 h~72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney u-test and the chi square test. Statistical significance was defined as P<0.05. Results Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in group 3 (P= 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in group 3. Conclusions It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients