低氮低热量肠外营养对腹腔镜大肠癌术后患者短期疗效的影响  

The short-term impact of hypocaioric and hyponitrogenic parenteral nutrition in patients after lapa- roscopic radical resection for coiorectal cancer

作　　者：周宏[1] 周晓聪[1] 夏建福[1] 杨大庆[1] 方阳[1] 李日增[1] 

机构地区：[1]温州医学院定理临床学院(温州市第二人民医院)肛肠外科,325000

出　　处：《中华实验外科杂志》2012年第9期1834-1836,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察术后低氮低热量营养支持对腹腔镜大肠癌术后患者短期疗效的影响。方法将84例结直肠癌患者随机分为研究组和对照组，研究组（n=42）采用标准化肠外营养液明旨肪乳氨暴酸（17）葡萄糖（11％）沣射液]（卡文），平均摄入热量（73．35±8．37）k1／（kg·d），氮量（0．10±0．01）mol／（kg·d）。对照组（n=42）按患者所测定的静息量消耗值，平均摄入热量（125．58±8．37）kl／（kg·d），氮量（0．24±0．06）mol／（kg·d），采用“全合一”无菌配置标准提供，术后进行5d的肠外营养支持。观察两组血生化、并发症、术后住院时间。结果研究组血糖值升高的幅度及波动范同明黟小于对照组，差异有统计学意义（P〈0．01）。两组啦浆总蛋白、白蛋白、前白蛋白水平比较差异无统计学意义（P〉0．05）。肺部感染、泌尿道感染、切口感染并发症发生率两组差异无统计学意义（P〉0．05）。总感染性并发症发生率（研究组7．1％比对照组23．8％，P〈0．05），静脉炎发生率（2．4％比21．4％，〈0．01），仝身炎症性反应综合征发生率（SIRS，21．4％比47．6％，P〈0．05），差跸有统计学意义。术后住院时间：研究组为（10．5±3．7）d，对照组为（11．2±4．0）d，差异无统计学意义（P〉0．05）。结论腹腔镜大肠癌根治术后低氮、低热量肠外营养比较传统肠外营养能更好的控制术后血糖水平，降低了总感染性并发症发生率及静脉炎、SIRS发生率。Objective To evaluate the sh~,rt-term impact of hypoealoric and hyponitrogenic paren- teral nutrition （PN） in patients after laparoscopic radieal resection for coloreetal cancer. Methods Eighty- four patients with colorectal carcinoma were randomly divided into two groups. Study group （ n = 42） re- ceived calorie （73.35 ＋8.37） kJ/（kg-day） and nitrogen （0. 10 ＋0. 01 ） mol/（kg.d） using a standard- ized regimen （KabivenTM PI, Fresenius Kabi, Germany）. Control group （n = 42） received calorie （ 125.58 ＋ 8.37 ） k J/（ kg. day） and nitrogen （0. 24 ＋ 0. 06） mol/（kg.day） in regular ＂3 liter bag＂. PN was infused continuously for 5 days postoperatively. Biochemical indicators, infectious complications and postoperative hospital stay were recorded to identify the difference between the two groups. Results The fluctuations of blood glueose levels in study grnup were lower than those in control group with significant ditt^rence （ P 〈 0. 05）. Comparison of serum concentrations of total protein, albumin and prealbumin be- tween two groups had no significant difference （P 〉 0.05）. Comparison of the complication rate of pulmo- nary infeetion, urinary tract infection and wnund infection between two groups had no significant difference （ P 〉 0. 05 ）. The total infectious complication rate in study group was 7.1% , significantly lower than that in control group （23.8% ,P 〈0. 05 ）. The phlebitis rate in study group was 2. 4% , significantly lower than that in control group （21.4% ,P 〈0. 01 ） , and the systemic inflammatory response syndrome （SIRS） rate in study group was 21.4% , significantly lower than that in control group （47.6% ,P 〈 0. 05 ）. But there was no significant difference in the postoperative hospital stay between the two groups （P 〉 0. 05 ）. Conclusion Hypoalorie amt hyponitrogenic PN after laparoseopie radical resection of colorectal cancer can con- /rol postoperative blood glucose levels better than traditional PN d

关 键 词：肠外营养 大肠肿瘤 腹腔镜 血糖 

分 类 号：R735.34[医药卫生—肿瘤]