营养支持治疗在食管癌术后的应用价值  

Application value of nutritional support therapy after resection of esophageal cancer

作　　者：殷静静[1] 林玉芬 

机构地区：[1]山东大学附属省立医院胸外微创肺移植科,济南250021 [2]山东省日照市岚山区人民医院心内科,276807

出　　处：《中华消化外科杂志》2015年第11期953-956,共4页Chinese Journal of Digestive Surgery

基　　金：山东省自然科学基金（ZR2014HQ073）;山东省重点研发项目（2015GSF118109）

摘　　要：目的探讨营养支持治疗在食管癌术后的应用价值。方法回顾性分析2013年5-11月山东大学附属省立医院收治的125例食管癌患者的临床资料。58例营养风险筛查2002（NRS2002）评分≥3分的患者设为A组，其中43例行营养支持治疗患者设为A1组，15例未行营养支持治疗患者设为A2组；67例NRS2002评分〈3分的患者设为B组，其中29例行营养支持治疗患者设为B1组，38例未行营养支持治疗患者设为B2组。患者入院后48h内采用NRS2002判定营养风险。NRS2002评分≥3分为有营养风险，〈3分为无营养风险。有营养风险患者应于术后尽早行营养支持治疗，告知患者及家属不行营养支持治疗的风险，由患者及家属自行选择。肠外营养支持治疗采用静脉输注葡萄糖、脂肪乳、氨基酸中的2种。肠内营养支持治疗包括管饲和口服营养素。营养支持治疗给予能量≥10kcal／（kg·d），持续时间≥5d。计算有营养风险患者中营养不良发生率；检测患者术前、术后3d、术后7d血清Alb和前白蛋白水平，以及术后胃肠功能恢复时间、术后住院时间。计数资料比较采用∥检验。正态分布的计量资料以x±s表示，组间比较采用LSD—t检验，重复测量数据采用重复测量方差分析。结果A组58例有营养风险患者中，51例患者已存在营养不良，发生率为87．9％。43例行营养支持治疗患者均耐受良好，无明显腹痛、腹胀、腹泻情况。A组中A1组患者术前、术后3d、术后7dAlb分别为（29．4±1．7）g/L、（29．8±1．5）g/L、（32．2±2．3）g／L，A2组分别为（28．5±1．9）g/L、（27．0±1．8）g/L、（28．3±1．7）g/L，2组变化趋势比较，差异有统计学意义（F=2．541，P〈0．05）；B组中B1组分别为（35．8±1．3）g/L、（36．0±1．4）g/L、（37．4±2．1）g／L，B2组分别为（34．5±1．3）g/L、（35．3±1．7）g／L、（36．3±1．5）g／L，2组变�Objective To investigate the application value of nutritional support therapy after resection of esophageal cancer. Methods The clinical data of 125 patients with esophageal cancer who were admitted to the Shandong Provincial Hospital Affiliated to Shandong University between May and November 2013 were retrospec- tively analyzed. According to the Nutritional Risk Screening 2002 （ NRS 2002 ） , 58 patients with scores of NRS 2002 ≥3 were allocated to the A group including 43 receiving nutritional support therapy in the A1 group and 15 receiving no nutritional support therapy in the A2 group; 67 patients with scores of NRS 2002 〈 3 were allocated to the B group including 29 receiving nutritional support therapy in the B1 group and 38 receiving no nutritional support therapy in the B2 group. The NRS 2002 was used as a screening tool of nutritional risk within 48 hours after admission. There was nutritional risk in patients with scores of NRS 2002/〉 3 and no nutritional risk in patients with seores of NRS 2002 〈 3. Patients and their families would choose whether or not underwent nutritional support therapy after the risks being informed. Parenteral nutritional support therapy used any 2 kinds of intrave- nously infusions of glucose, fat emulsion and amino acid, and enteral nutritional support therapy included tube feeding enteral nutrition or oral nutriments. The calories I〉 10 kcal./（ kg ~ d） were offered for more than 5 days. The incidence of malnutrition in patients with nutritional risk was calculated, and the level of serum Alb and preal- bumin before operation, at postoperative day 3 and day 7, postoperative recovery time of gastrointestinal function and duration of hospital stay were detected. Count data were analyzed using the ehi-square test. Measurement data with normal distribution were presented as ~ _＋ s. Comparison among groups was analyzed using the LSD-t test, and repeated measures data were analyzed by the repeated measures ANOVA. Results Of 58 patients in the A group, 51 patients

关 键 词：食管肿瘤 营养支持治疗 营养风险筛查2002 

分 类 号：R735.1[医药卫生—肿瘤]