鼻饲管在肝癌介入术后营养支持中的临床应用  

Nutritional support with nasogastric feeding tube after transcatheter arterial chemoembolization in hepatic carcinomas

作　　者：李闯[1] 张跃伟[1] 唐顺雄[1] 周军[1] 赵广生[1] 赵旭[1] 

机构地区：[1]大连大学附属中山医院介入科,辽宁大连116001

出　　处：《实用放射学杂志》2014年第7期1190-1193,共4页Journal of Practical Radiology

摘　　要：目的：探讨介入术前在 DSA 引导下放置鼻饲管，术后进行肠内营养支持对存在营养风险的老年肝癌患者临床结局的影响。方法选取接受肝癌介入治疗，术前给予营养风险筛查，并在 DSA 引导下放置鼻饲管，术后经鼻饲管行肠内营养支持的33例患者为研究组。选取肝癌介入术前未进行营养风险筛查，未放置鼻饲管，术后行肠外营养支持的同类患者33例为对照组。比较2组患者术后营养指标的变化和全身炎性反应综合征的发生率、感染并发症的发生率和术后住院时间。结果研究组体重变化与血浆白蛋白水平变化和对照组比较差异无统计学意义，感染并发症发生率和术后住院时间显著低于对照组，差异有统计学意义。结论对于老年肝癌介入治疗患者，入院时应行营养风险筛查，有营养风险者，可于 DSA 引导下放置鼻饲管，术后进行联合营养支持，有利于促进患者术后营养状态的恢复。Objective To discuss interventional procedures before feeding tube placed in the DSA guidance,influence postoperative enteral nutrition support for the presence of nutritional risk of clinical outcomes in elderly patients with hepatocellular carcinoma. Methods 33 patients acquired with interventional therapy of hepatic carcinoma were selected as the study group.All of patients un-derwent preoperatively the nutritional risk screening and insertion of nasogastric feeding tube under DSA.Enteral nutritional support by the nasogastric feeding tube was used after interventional therapy.33 similar patients underwent parenteral nutritional support af-ter international therapy were selected as the control group.The change of the nutritional indexes,the incidence of the systemic in-flammatory response syndrome,the incidence of infection,and the length of hospital stay after operation were compared between the two groups.Results There were no significant differences in the plasma albumin levels and body weight changes compared between the two groups （P 〉0.05）.However,the incidence of infection and the length of hospital stay were lower significantly in the study group than in the control group （P ＆gt;0.05）.Conclusion The nutritional risk screening before interventional treatment is necessary for the elder patients with hepatic carcinoma.The patients with nutritional risk can be placed the nasogastric feeding tube preopera-tively under DSA,and perform combined nutritional support to promote the recovery of nutritional state after operation.

关 键 词：老年人 肝癌 肝动脉化疗栓塞 鼻饲管 营养支持 

分 类 号：R357[医药卫生—基础医学] R815