全营养混合液对胃癌根治术后恢复的影响  

Effects of total nutrient admixture on the recovery of patients with gastric cancer after radical gastrectomy

作　　者：刘庆[1] 刘亿[1] 冯立波[1] 夏冬[1] 徐亮[1] 

机构地区：[1]泸州医学院附属医院胃肠外科,646000

出　　处：《中华消化外科杂志》2015年第5期386-389,共4页Chinese Journal of Digestive Surgery

基　　金：四川省卫生厅支撑计划基金（B2007011）

摘　　要：目的 探讨全营养混合液对胃癌根治患者术后恢复的影响.方法 回顾性分析2013年3月至2014年3月泸州医学院附属医院收治的50例胃癌患者的临床资料.50例患者行胃癌根治术,其中26例患者采用全营养混合液行营养支持治疗设为试验组,24例患者采用常规补液治疗设为对照组.试验组患者术前5d、术后1∽5d采用全营养混合液行营养支持治疗,对照组患者采用传统的术后补液方式补充液体、葡萄糖、电解质、维生素和微量元素.观察患者营养支持治疗前和治疗后（术后8d）的营养指标（Alb、前白蛋白、转铁蛋白、Hb）,术后肛门排气时间,术后并发症情况（切口感染、吻合口漏、出血、肠梗阻）和住院时间.计数资料采用χ2检验,1≤最小理论频数≤5,采用连续性矫正卡方值;正态分布的计量资料以（x）±s表示,采用t检验,营养指标分析采用协因素方差分析,等级资料分析采用秩和检验.结果 试验组患者营养支持治疗前Alb、前白蛋白、转铁蛋白、Hb分别为（38.6±2.0）g/L、（281±33） mg/L、（2.5±0.9）g/L、（111±20） g/L,术后8d上述指标分别为（38.2±1.9）g/L、（277±16）mg/L、（2.3±1.1）g/L、（112±37） g/L;对照组营养支持治疗前Alb、前白蛋白、转铁蛋白、Hib分别为（38.3±2.4） g/L、（287±34） mg/L、（2.4±1.1）g/L、（107±21） g/L,术后8d上述指标分别为（30.3±2.3）g/L、（190±41）mg/L、（1.6±0.3）g/L、（93±22） g/L.试验组和对照组患者术后8d营养指标比较,差异均有统计学意义（F=174.042,95.637,9.529,4.919,P＜0.05）.试验组和对照组患者术后肛门排气时间分别为（52±11）h、（70±12）h,两组比较,差异有统计学意义（t=-5.176,P＜0.05）.试验组患者并发症发生率为15.4％（4/26）,对照组患者并发症发生率为58.3％（14/24）,两组比较,差异有统计学意义（χ2=6.460,P＜0.05）.两组患者并发症经抗感染、对症支�Objective To investigate the effects of total nutrient admixture （TNA） on the recovery of patients with gastric cancer after radical gastrectomy.Methods The clinical data of 50 patients with gastric cancer who were admitted to the Affiliated Hospital of Luzhou Medical College between March 2013 and March 2014 were retrospectively analyzed.Among 50 patients receiving radical gastrectomy,26 patients receiving TNA were allocated to the experimental group and 24 patients receiving conventional fluid infusion were allocated to the control group.Patients in the experimental group received the nutritional support therapy using TNA at preoperative day 5 and at postoperative days 1-5,and patients in the control group received the postoperative intravenous rehydration including water,glucose,electrolyte,vitamins and micro elements.The nutritional indexes [albumin （Alb）,prealbumin,transferrin and hemoglobin （Hb）],time to anal exsufflation,incidence of complications （wound infection,anastomotic leakage,blooding and intestinal obstruction） and duration of hospital stay were observed before nutritional support therapy and at postoperative day 8.The count data were analyzed using the chi-square test.The chi-square value of correction for continuity was used when 1 ≤ minimum theoretical frequency ≤ 5.The measurement data with normal distribution were presented as （x） ±s and analyzed using the t test or repeated measures ANOVA.The ordinal data were analyzed by the analysis of variance.Results The Alb,prealbumin,transferrin and Hb in the experimental group were （38.6 ± 2.0） g/L,（281 ± 33） mg/L,（2.5 ± 0.9） g/L and （111 ± 20） g/L before nutritional support therapy and （38.2 ± 1.9） g/L,（277 ± 16） mg/L,（2.3 ± 1.1） g/L and （112 ± 37） g/L at postoperative day 8,respectivley.The Alb,prealbumin,transferrin and Hb in the control group were （38.3 ±2.4） g/L,（287 ± 34） mg/L,（2.4 ± 1.1） g/L and （107 ± 21） g/L before nutritional support therapy and （30.3 ±2.

关 键 词：胃肿瘤 营养支持治疗 肠外 围术期 

分 类 号：R735.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]