目的 比较真实世界中食管癌患者在加速康复外科理念下给予肠内营养的不同时机对患者术后恢复情况的影响。 方法 采用便利抽样的方法选取 2020 年 4 月至 2021 年 4 月于中国医学科学院北京协和医学院肿瘤医院胸外科行加速康复外 科治疗的食管癌患者为研究对象。 最终共纳入食管癌患者 102 例,其中 51 例患者术后完全清醒后 2~ 6 h 给予肠内营养(简称 2 h 组),51 例患者术后 24 h 内给予肠内营养(简称标准组)。 应用 R 语言及 Matchlt 包将两组患者进行倾向性评分匹配。 比 较两组患者术后肠道功能恢复、口渴状况、营养状态、不良反应及并发症发生率。 结果 两组患者差异无统计学意义,具有可 比性(P>0. 05)。 2 h 组患者首次排气时间和排便时间均早于标准组(P<0. 05)。 2 h 组患者口渴痛苦评分(TDS)和口渴数字 评分(NRS)均小于标准组患者(P>0. 05)。 2 h 组患者前白蛋白含量高于标准组(P<0. 05)。 两组患者消化道不适情况及并发 症发生情况差异无统计学意义(P>0. 05)。 结论 食管癌患者加速康复外科术后清醒后 2 ~ 6 h 给予肠内营养可促进胃肠功能 恢复,改善患者口渴情况和营养指标,同时具有较好安全性。

Objective To compare the effect of different timing of enteral nutrition for esophageal cancer patients after enhanced recovery after surgery in the real world. Method A total of 102 esophageal cancer patients after enhanced recovery after surgery were chosen by convenience sampling in thoracic surgery department of a hospital in Beijing from April 2002 to April 2021. 51 of them received enteral nutrition 2-6 h after totally awake after surgery 2 h group for short 51 of them received enteral nutrition 24 h after operation 24 h group for short . R language and Matchlt were used for propensity score matching. We compared the gastrointestinal function the thirsty status the nutrition status the incidence of the adverse reaction and complications of the two groups. Result A total of 51 pairs of patients were matched finally. There was no statistical significance between them P>0. 05 . The first time of exhaust and defecation after operation of 2 h group were shorter than those of 24 h group P<0. 05 . The scores of TDS and NRS were less than those of 24 h group P<0. 05 . The levels of serum albumin was higher than that of 24 h group P<0. 05 . However the difference of adverse reaction and complications between two groups was no statistical significance P>0. 05 . Conclusion Giving enteral nutrition 2 -6 h after totally awake after surgery for esophageal cancer patients could promote the recovery of gastrointestinal function thirsty situation and nutrition index with good safety.