肿瘤患者肠内、外营养及围术期营养支持用药现状分析  

Analysis of Enteral and Parenteral Nutrition and Drug Use of Perioperative Nutritional Support in Cancer Patients

作　　者：杨锐[1,2] 方玉[1,2] 辛晓伟[1,2] 王艳莉[1,2] 

机构地区：[1]北京大学肿瘤医院 [2]北京市肿瘤防治研究所/恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142

出　　处：《中国药房》2011年第42期3955-3959,共5页China Pharmacy

摘　　要：目的:了解肿瘤患者肠内、外营养药物的应用情况及围术期的营养支持现状。方法:调查某"三甲"肿瘤专科医院2002、2005、2010年肠内、外营养药物的消耗情况及2010年5月采用营养支持治疗的外科手术出院患者260份病历,对照《临床诊疗指南——肠外肠内营养学分册》,分析肠内、外营养药物的应用变化趋势。结果:该院肠内、外营养药物的用量不断上升,2005年较2002年增加18.23%,2010年较2005年增加54.44%,尤其在外科围术期消化系肿瘤患者中用量最多;临床尚存在肠内肠外营养药应象用,术倒前置9问4.7题%,和26术0例后中35肠.9内%与的肠患外者营营养养支支持持的不时足间5比d,为术后1∶3前,日3天均有费用23比.3%为的1∶患4.2者;还每存天在热营量养>支25持k不cal·足k和g-营1。养结支论持:营过养度支并持存治等疗现在该院逐渐被临床医师所重视,但其应用的合理性尚需规范。OBJECTIVE： To survey the application of enteral and parenteral nutrition in cancer patients and status quo of perioperative nutritional support. METHODS： The consumption of enteral and parenteral nutritious substances was investigated in a class three grade A cancer hospital in 2002,2005,2010. Medical records of 260 discharged patients receiving nutritional support after surgery were investigated in May 2010. The trends of enteral and parenteral nutritious were analyzed according to the book ＂Clinical Practice Guidelines-Parenteral and Enteral Nutrition Science Volume＂. RESULTS： The amount of enteral and parenteral nutrition increased continuously in the hospital, increased by 18.23% in 2005 compared with in 2002, by 54.44% in 2010 compared with in 2005, especially in patients with gastrointestinal tumors during the perioperative period. There was problem of the reverse between enteral and parenteral nutrition. Among 260 cases, the time ratio of nutrition support between enteral and parenteral nutrition was 1∶3, the average daily cost ratio was 1∶4.2. There was still the coexistence of deficiency and excessive feeding. 94.7% of preoperative patients and 35.9% of postoperative patients got nutritional support less than 5 days, 23.3% of patients got daily calories more than 25 kcal·kg-1 during the first 3 days after operation. CONCLUSION：Nutritional support gradually gets attention by clinicians, but the rationality of drug use needs to be standardized.

关 键 词：肿瘤患者 肠内营养 肠外营养 围术期 营养支持 分析 

分 类 号：R969.3[医药卫生—药理学] R287[医药卫生—药学]