两种短期肠内-外联合营养方案对胃癌患者术后营养状况的影响  

Effect comparison of two protocols of short-term partial parenteral nutrition on postoperative nutritional condition in patients with gastric cancer

作　　者：王敏[1] 朱耀东[2] 蒋红钢[1] 陆伯豪[1] 

机构地区：[1]嘉兴学院附属第一医院肿瘤外科,314000 [2]嘉兴学院科技处,314000

出　　处：《中国医药》2016年第2期235-238,共4页China Medicine

基　　金：浙江省科技计划项目（2012C23100）

摘　　要：目的探讨2种短期肠内-夕h联合营养方案（PPN）对胃癌患者术后营养状况的影响。方法选取2010年1月至2014年12月40例嘉兴学院附属第一医院肿瘤外科收治的可切除胃癌患者，术前随机分成PPN肠内营养渐增组（21例）、PPN肠内营养恒量组（19例）。2组均于术后第2天开始接受PPN，PPN肠内营养渐增组术后第2～3天持续滴注百普力液，500ml／d，术后第4～6天增至1000ml／d。PPN肠内营养恒量组术后第2—6天持续滴注百普力液，500ml／d。2组均给予PPN5d。比较2组患者术前和术后第3、6天的营养状况，观察指标包括体质量、臂围、血清总蛋白、血清白蛋白和血清前白蛋白。结果术后第6天，2组患者的体质量和臂围与术前比较差异无统计学意义（P〉0．05）。PPN肠内营养渐增组血清总蛋白在术后第3、6天低于术前，差异有统计学意义[（55±5）、（58±5）g／L比（65±4）g/L，P〈0．05]，而PPN肠内营养恒量组术后与术前比较差异无统计学意义（P〉0．05）。PPN肠内营养渐增组术后第3、6天及PPN肠内营养恒量组术后第3天血清白蛋白水平低于术前，差异有统计学意义[（33．2±6．2）、（34．6±5．2）g／L比（39．0±6．7）g／L，（32．5±2．9）g／L比（36．4±5．7）g／L，P〈0．05]。PPN肠内营养渐增组和PPN肠内营养恒量组术后第3天血清前白蛋白水平低于术前，差异有统计学意义[（111±69）mg／L比（175±62）mg／L、（93±12）mg／L比（143±42）mg／L，P〈0．05]，但术后第6天与术前比较差异无统计学意义（P〉0．05）。结论胃癌术后患者中，肠内营养恒量性PPN方案与肠内营养渐增PPN方案比较，可改善患者的营养状况。Objective To investigate the effect of two protocols of short-term partial parenteral nutrition （PPN） on postoperative short period nutritional condition in patients with gastric cancer. Methods Forty patients with gastric cancer who were give PPN on the second day after operation from January 2010 to December 2014 were randomly divided into PPN escalation group （21 cases） and PPN constant group （19 cases）. PPN escalation group was continuously given peptison liquid 500 ml/d on the 2nd-3rd day, and increased to 1 000 ml/d on the 4th-6th day; PPN constant group was continuously given peptison liquid 500 ml on the 2nd -6th day. The nutritional indexes including body weight, arm circumference, serum total protein, serum albumin and serum prealbumin before and after operation were compared between groups. Results The body weight and arm circumference 6 days after operation were not significantly decreased compared with those before operation （P 〉 0. 05 ）. The serum total protein 3 and 6 days after operation was significantly decreased compared with that before operation in PPN escalation group [ （55 ± 5 ）, （ 58 ± 5 ） g/L vs （ 65 ± 4） g/L ] （ P 〈 0. 05 ）, while was not significantly changed in PPN constant group （P 〉 0. 05）. The serum albumin 3 and 6 days after operation in PPN escalation group, 3 days after operation in PPN constant group was significantly lower than that before operation [ （ 33.2 ± 6. 2 ）, （ 34. 6 ± 5.2） g/Lvs （39.0±6.7） g/L; （32.5±2.9） g/L vs （36.4±5.7） g/L] （P〈0.05）. The levels of serum prealbumin 3 days after operative was significantly lower than that before operation in both groups [ （111 ± 69） mg/L vs （ 175 ± 62） mg/L, （93 ± 12） mg/L vs （ 143 ± 42） mg/L ] （ P 〈 0. 05 ）, but it was not significantly change 6 day after in both groups （ P 〉 0. 05）. Conclusion Compared with escalation PPN, the constant PPN program is more helpful for improving patient＇s nutritional condition after gastric

关 键 词：胃癌 肠内营养 营养状况 

分 类 号：R735.2[医药卫生—肿瘤]