联合脏器切除术治疗进展期胃癌术后应用TPN的临床研究  

Total parenteral nutrition and combined resection of involved organs in gastric cancer

作　　者：任鹏[1] 周克俭[1] 李洪林[1] 丁文贤[1] 王福贻[1] 

机构地区：[1]山东省滨州市中心医院普外科,山东滨州251700

出　　处：《中国现代普通外科进展》2009年第8期695-698,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:研究联合脏器切除术结合术后完全胃肠外营养(TPN)治疗进展期胃癌的临床价值。方法:选择我院普外科2001年6月─2006年11月施行联合脏器切除结合术后TPN的67例进展期胃癌患者为实验组,同期149例其他胃癌患者为对照组,将2组资料进行对照分析。结果:实验组联合肝切除6例,脾切除12例,横结肠切除7例,胆囊切除8例,副肾上腺切除2例,脾胰体尾切除19例,胰十二指肠切除7例,小肠部分切除4例,单侧卵巢切除2例,手术死亡率为0。实验组术后转铁蛋白、白蛋白、纤维连接蛋白、自然杀伤细胞(NK)、淋巴因子杀伤细胞(LAK)、T细胞亚群下降程度明显较对照组轻,差异有统计学意义(P<0.01);术后7d,实验组各项指标上升,与对照组比较,差异有统计学意义(P<0.01);随访1、3和5年,实验组生存率分别为59.6%、25.9%和15.8%。结论:严格掌握手术适应证,联合切除受累脏器,术后应用TPN可作为治疗进展期胃癌的合理方法,有助于提高进展期胃癌切除的安全性,降低术后并发症,提高生存率。Objective：To explore the effect of total parenteral nutrition and combined resection of involved organs on gastric cancer. Methods： The clinical data of 67 patients with advanced gastric cancer who had accepted total parenteral nutrition（TPN）and combined resection of involved organs between June,2001 and November,2006 were reviewed and compared with no TPN patients. Results： Combined resection organs included spleen and pancreas tail（19 cases）, spleen（12 cases）, gallbladder（8 cases）, transverse colon（7 cases）, etc. No patient died in hospital in both TNP group and no TNP group. Compared with the control group, the levels of blood transferrin, albumin, and natural killer cells increased in TPN group in 7 days after operation （P〈0.01）. The survival rate were 59.6%, 25.9% and 15.8%, respectively, after 1, 3, 5 years follow-up. Conclusion： Handling the indication strictly, TPN and combined resection of involved organs is effective in gastric cancer treatment.lt conduces to enhance the safety of the operation, decrease the incidence of postoperative complication, increase the survival rate of the patients with gastric cancer.

关 键 词：胃肿瘤 胃切除术 胃肠外营养 全 

分 类 号：R735.2[医药卫生—肿瘤]