33例食管癌患者围术期补充乳清蛋白粉对术后并发症的预防作用  

Preliminary observation of perioperative whey protein supplementation for the prevention of postoperative complications in 33 patients with esophageal cancer

作　　者：王艳莉[1] 冯晔 周秀耕[2] 杨跃[2] 吴楠[2] 方玉[1] 阎石[2] 李少雷[2] 吕超[2] 韩超[2] 杜松涛[2] WANG Yanlig;FENG Ye;ZHOU Xiugeng;YANG Yue;WU Nan;FANG Yu;YAN Shi;LI Shaolei;LYU Chao;HAN Chao;DU Songtao(Department of Nutrition,Beijing Cancer Hospital&Beijing Institute for Cancer Research,Beijing 100142,China;Department of Thoracic Surgery,Beijing Cancer Hospital&Beijing Institute for Cancer Research,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所营养科,北京100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所胸外科,北京100142

出　　处：《山东大学学报（医学版）》2022年第3期64-70,共7页Journal of Shandong University:Health Sciences

基　　金：北京市委组织部、北京市优秀人才资助项目(2018000021469G270)

摘　　要：目的探讨围术期补充乳清蛋白对食管癌术后并发症发生率及营养状态的影响。方法选取2017年4月至2018年6月某医院择期食管癌切除术的患者为研究对象,按1∶1将患者随机分为观察组和对照组,通过营养风险筛查表(NRS2002)、患者主观整体评估量表(PG-SGA)、人体成分测定等对两组患者于术前门诊、术前1天、术后1个月进行营养和身体方面的评估。两组患者均进行常规营养干预。此外,观察组在术前门诊还开始补充乳清蛋白粉,干预周期至术后1个月。比较两组术后1个月的并发症发生率[并发症界定为2级以上的感染相关的并发症(包括肺部感染、呼吸道感染、吻合口瘘等)];比较基线、术前1天、术后1个月营养状态的差异。结果两组患者术后并发症的发生率,观察组为24%(8/33),对照组为49%(18/37),两组差异有统计学意义(P<0.05)。其他观察指标2组间差异没有统计学意义。结论围术期补充乳清蛋白联合肠内营养可以有效降低食管癌术后1个月的感染性并发症的发生率,但样本量小,还有待进一步验证。Objective To investigate the effects of whey protein on the postoperative complications and nutritional status of patients with esophageal cancer.Methods Patients with esophageal squamous cell cancer who underwent elective surgery during April 2017 and June 2018 were enrolled and randomly divided into observation group and control group at a ratio of 1:1.Nutritional risk screening 2002(NRS2002),Patient-Generated Subjective Global Assessments(PG-SGA)and composition measurement were used to screen and evaluate the nutritional status before operation,one day before operation and one month after operation.All patients were given basic nutritional support.In addition,whey protein powder was given to the observation group,and the intervention was continued until 1 month after surgery.The incidence of complications(above grade 2 complications including lung infection,respiratory tract infection,anastomotic leakage)was compared one month after surgery;the differences in nutritional status were compared at baseline,one day before surgery and one month after surgery.Results The incidence of complications was 24%in the observation group and 49%in the control group(P<0.05).There were no differences in the other indicators.Conclusion Preoperative whey protein supplementation combined with enteral nutrition can effectively reduce the incidence of infectious complications in patients with esophageal cancer one month after surgery.However,our sample size is small and the research results need to be further verified.

关 键 词：食管癌 乳清蛋白 肠内营养 并发症 

分 类 号：R735.1[医药卫生—肿瘤]