目的  探讨肠内营养和肠外营养对消化道恶性肿瘤患者营养状况的影响。方法  选取河北工程大学附属医院及 邯郸市中心医院2016 年 10 月至2018 年 2 月收治的消化道恶性肿瘤患者作为研究对象，运用营养风险筛查工具和整体 营养状况主观评估两种方法进行营养风险筛查及评估，结果显示，存在营养风险的患者有200 例，按照随机数字表法将 其分为观察组（100 例）和对照组（100 例），对照组实施肠外营养，观察组实施肠内营养。结果  两组在性别、平均年龄、 平均体质指数、平均血红蛋白、平均总蛋白、平均白蛋白、平均前白蛋白以及癌变部位的比较没有统计学差异（P 值均 ＞ 0.05）；经过两周的营养治疗，血红蛋白、白蛋白水平观察组明显高于对照组，差异具有统计学意义（P ＜ 0.01）； 但两组的前白蛋白、总蛋白水平比较差异无统计学差异（P 值均＞ 0.05）；观察组的并发症发生率为 8%，明显低于对照 组的发病率 19%（P ＜ 0.05）。结论  消化道恶性肿瘤患者营养风险发生率较高，高营养风险会导致并发症发生率升高； 与肠外营养治疗相比，肠内营养更适于改善消化道恶性肿瘤患者的营养状况。

Objective  To investigate the effect of enteral nutrition and parenteral nutrition on the nutritional status of patients with gastrointestinal cancer after operation. Methods  Selected patients with gastrointestinal cancer in Affliated Hospital of Hebei University of Engineering and Handan Central Hospital from October 2016 to February 2018 evaluated the nutritional status by were using nutritional risk screening tool (NRS-2002) and scored patient-generate subjective global assessment (PG-SGA). The results showed that  there were 200 patients with high nutritional risk. According to random number table method, the patients  were divided into observation group and control group with 100 cases in each group. The control group were administrated  parenteral nutrition treatment and the observation group were received enteral nutrition therapy. Results  The incidence of complications in patients with no nutritional risk was 12.5% (27/216), and in patients with risk was 23% (46/200). The difference was statistically significant (P<0.05). Gender, mean age, mean body mass index (BMI), hemoglobin (HGB), total protein (TP), albumin (ALB), prealbumin (PA) and the types of cancer between two groups were l no statistical significance (all P>0.05). Two weeks after the nutritional therapy, hemoglobin (HGB), albumin (ALB) level of observation group were both significantly higher than those of the control group, and the difference was statistically significant (P<0.05). However, there was no statistical difference between the two groups of prealbumin (PA) and total protein (TP) (P>0.05). The incidence of complications in the study group was 8% and lower than that of the control group which was 19% (P<0.05). Conclusions  The incidence of nutritional risk is high in patients with gastrointestinal cancer, which can lead to higher incidence of complications. Enteral nutrition therapy of patients with gastrointestinal cancer can  effectively improve the nutritional status compared to parenteral nutrition treatment.