【摘要】 目的 探讨术前预康复联合阶段性营养支持在食管癌(EC)和食管胃结合部腺癌(AEG)手术患者中的应用效果。方法 纳入河西学院附属张掖人民医院2022年10月—2023年10月收治的EC和AEG患者120例，随机分为对照组[给予常规康复+肠内营养(EN)干预]、观察组(给予常规康复+阶段性营养支持)和实验组(给予术前预康复+阶段性营养支持),每组40例。分别于入院时和术后第15天检测健康指标(体质量、体水分、细胞内水分、蛋白质、无机盐)、血清营养指标(白蛋白、前白蛋白、转铁蛋白和血红蛋白)、血清肠道功能指标(内毒素、二胺氧化酶、D-乳酸)和免疫功能指标(IgG、IgA、IgM)水平。采用QLQ-C30量表评估生活质量。结果 与对照组和观察组比较，实验组患者术后第15天的体质量升高(P<0.05)。与对照组比较，观察组和实验组患者术后第15天的血清营养指标含量均升高(P<0.05)。观察组与实验组患者的营养指标差异无统计学意义(P>0.05)。与对照组和观察组比较，实验组患者术后第15天的血清二胺氧化酶和D-乳酸含量降低(P<0.05),血清IgG、IgA和IgM含量均升高(P<0.05),术后并发症发生率显著降低(χ~2=7.169,P=0.028),功能和总健康状况领域得分均升高(P<0.05),症状领域得分除便秘、腹泻和经济困难领域之外均降低(P<0.05)。结论 术前预康复联合阶段性营养支持有效改善了EC和AEG患者术后的营养指标、肠道功能和免疫功能，降低了术后并发症发生率，改善了生活质量，具有较高的临床应用价值。更多还原

【Abstract】 Objective To investigate the effect of preoperative pre-rehabilitation combined with phased nutritional support in patients with esophageal cancer（EC） and adenocarcinoma of esophagogastric junction（AEG）. Methods From October 2022 to October 2023, patients with EC and AEG in our hospital were randomly divided into control group（routine rehabilitation + enteral nutrition（EN） intervention）, observation group（routine rehabilitation + phased nutritional support） and experimental group（preoperative pre-rehabilitation + phased nutritional support） with 40 cases in each group. Body composition（body mass, body moisture, intracellular water, protein, inorganic salt）, serum nutrition index（albumin, prealbumin, transferrin and hemoglobin）, serum intestinal function index（endotoxin, diamine oxidase, D-lactic acid） and immune function index（IgG, IgA, IgM） were measured on admission and on the 15^th day after operation. QLQ-C30 scale was used to evaluate the quality of life. Results Compared with control group and observation group, the body mass of patients in experimental group increased on the 15th day after operation（P<0.05）. Compared with control group, the contents of serum nutritional indexes in observation group and experimental group increased on the 15th day after operation（P<0.05）. There was no significant difference in nutritional indexes between observation group and experimental group（P>0.05）. Compared with control group and observation group, on the 15th day after operation, the contents of serum diamine oxidase and D-lactic acid in experimental group decreased（P<0.05）, while the contents of serum IgG, IgA and IgM increased（P<0.05）, the incidence of postoperative complications decreased（χ²=7.169, P=0.028）, the scores of functional and total health status increased（P<0.05）, and the symptom area scores decreased in all areas except constipation, diarrhea, and economic hardship（P<0.05）. Conclusion Preoperative pre-rehabilitation combined with phased nutritional support can effectively improve the nutritional index, intestinal function and immune function of patients with EC and AEG, reduce the incidence of postoperative complications and improve the quality of life.更多还原