肠外营养支持对消化道恶性肿瘤患者术后的干预作用  

Interventional effect of parenteral nutrition supporton postoperative patients with malignant gastrointestinal tumor

作　　者：周路琦[1] 王昆鹏[2] 杨婕[1] 孙超[3] 程艳芬[4] 

机构地区：[1]承德医学院附属医院营养科,河北067000 [2]承德医学院附属医院神经外科,河北067000 [3]承德医学院附属医院静脉用药调配中心,河北067000 [4]承德医学院附属医院介入中心,河北067000

出　　处：《临床外科杂志》2016年第4期280-283,共4页Journal of Clinical Surgery

基　　金：2013年承德市科学技术研究与发展计划资助项目(20132062)

摘　　要：目的探讨不同肠外营养(parenteral nutrition,PN)支持方案对消化道恶性肿瘤术后患者相关指标的干预作用。方法胃肠道术后患者66例随机分为常规输液组(A组)、低热量PN组(B组)、传统热量PN组(C组),每组22例,监测营养干预前、干预后第3、7天的生化指标情况。结果 3组患者不同检测时间的血清总蛋白(total protein,TP)、白蛋白(albumin,ALB)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)、γ—谷胺酰转肽酶(γ—glutamyl transpeptidase,γ-GT)、碱性磷酸酶(alka—line phosphatase,ALP)、血红蛋白(hemoglobin,HGB)和淋巴细胞百分率(1ymphocyte percentage,LYMPH)组内比较差异有统计学意义(P<0.05);分组因素对血清ALB、AST、ALT、ALP和LYMPH值的影响差异有统计学意义(P<0.05);时间与分组的交互因素对3组患者血清TP、ALB、AST、ALT、TBIL、ALP和LYMPH值均有影响,差异有统计学意义(P<0.05)。干预7天,B组血ALB值、LYMPH值均高于A、C组,血清AST、ALT和ALP值均低于A、C组(P<0.05);3组患者血TP、HGB值比较差异无统计学意义(P>0.05)。结论低热量PN支持方案对消化道恶性肿瘤患者术后营养、免疫和肝功能指标的干预效果优于常规输液组和传统热量PN组。Objective To study the effects of different parenteral nutrition support plans for patients with malignant gastrointestinal tumor. Method A total of 66 postoperative patients with gastrointestinal malignant tumor were randomly assigned to conventional transfusion group （group A）, low calorie parenteral nutrition group（ group B ）, and conventional calorie parenteral nutrition group（ group C ）. Blood indicators were observed at the day before intervention and the 3th and 7th day after intervention. Results Different testing time had effects on serum TP, AST, ALT, TBIL, γ-GT, ALP, HGB and LYMPH values, and the difference was statistically significant （ P 〈 0.05 ） ; the intervene methods had effects on serum ALB ,AST,ALT,ALP and LYMPH, and the difference was statistically significant（ P 〈0.05 ） ;the interaction factors of time and group had effects on serum TP, ALB, AST, ALT,TBIL, ALP and LYMPH, and the difference was statistically significant （P 〈 0.05 ）. At the 7th afterintervening, serum ALB and LYMPH values of group B was higher than group A and C, serum AST, ALT and ALP values were lower than group A and C（P 〈0.05） ;the difference of blood TP and HGB value among three groups has no statistical significance（P 〉 0.05）. Conclusion Low calorie parenteral nutrition has a better therapeutic effect than conventional transfusion and conventional calorie parenteral nutrition in controlling of nutrition, immunity and liver function of patients with malignant gastrointestinal tumor after operation.

关 键 词：低热量肠外营养 白蛋白 天冬氨酸氨基转移酶 丙氨酸氨基转移酶 淋巴细胞百分率 

分 类 号：R735[医药卫生—肿瘤]