胃肠道肿瘤患者围手术期不同营养支持方法的研究  

Perioperative nutritional support in patients with gastrointestinal carcinoma

作　　者：张军[1] 王严庆[1] 王致天[1] 王子卫[1] 

机构地区：[1]重庆医科大学附属第一医院普通外科

出　　处：《第三军医大学学报》2006年第8期844-846,共3页Journal of Third Military Medical University

摘　　要：目的探讨不同营养支持途径在胃肠道肿瘤患者围手术期营养状况及恢复中的作用。方法将51例胃肠道肿瘤且伴有营养不良的患者,行根治性手术后随机分为3组,对照组为术后常规补液5～7d,肠内营养(EN)组术后早期给予肠内营养支持5～7d,完全胃肠外营养支持(TPN)组术后采用TPN治疗3～5d,。并检测术前、术后营养状况指标及患者恢复情况。结果血清总蛋白、白蛋白、前白蛋白、转铁蛋白水平各项指标中,EN组、TPN组较术前降低,但差异无显著性,对照组术后较术前显著下降(P<0.05)。EN组、TPN组患者术后并发症及住院天数均少于对照组。结论术后肠内、外营养支持能够改善胃肠道肿瘤患者营养状况,减少术后并发症的发生、缩短住院天数。术后早期施行EN是安全、可行和有效的。Objective To evaluate the role of nutritional support in the patients with gastrointestinal neoplasms on nutritional status after surgical procedure. Methods Totally 51 patients with gastrointestinal carcinoma and malnutrition were involved in this study. The patients were randomly assigned to receive only routine intravenous infusion without any nutritional support for 5 to 7 d postoperatively （ control group） or early postoperative enteral nutrition for 5 to 7 d （group） or total parenteral nutrition support after operation for 3 to 5 d （ total parental nutrition group）. The nutrition status of the patients was detected before and after operation. Resuits The serum level of TSP, albumin, proalbumin, transferrin of enteral nutrition and total parental nutrition groups postoperatively decreased as compared with that before operation, but with no difference postoperatively between the two groups. In the control group, the postoperative serum level of total protein, albumin, proalbumin and transferrin decreased significantly （P 〈 0. 05 ） as compared to the preoperative level. The occurrence of postoperative complications and hospital stay of the enteral nutrition group and the total parental nutrition group were less than that of the control group. Conclusion The present study suggests that early postoperative total parental nutrition and enteral nutrition support can improve the patients＇ nutritional status, reduce the incidence of postoperative complications and hospital stay. Nutritional support at early stage after operation is safe, feasible and effective.

关 键 词：胃肠肿瘤 营养支持 全肠外营养 肠内营养 围手术期 

分 类 号：R459.3[医药卫生—治疗学] R730.56[医药卫生—临床医学]