术前肝储备功能及营养状态对肝癌行肝切除患者康复的影响  

Effect of Preoperative Liver Reserve Function and Nutritional Status on Liver Resection Postoperative Rehabilitation for Patients with Liver Cancer

作　　者：尹秀芬[1] 谭李军[1] 王苗苗[1] 李铂[1] YIN Xiu-fen TAN Li-jun WAN Miao-miao LI Bo(Hepatobiliary and Pancreatic Surgery Department, Affiliated Hospital of Guilin Medical College,Guilin 541001, Guangxi)

机构地区：[1]桂林医学院附属医院肝胆外科,桂林541001

出　　处：《临床护理杂志》2017年第3期2-4,共3页Journal of Clinical Nursing

基　　金：广西卫生厅自筹经费计划课题(Z2015393)

摘　　要：目的探讨术前肝储备功能及营养状态对肝癌行肝切除患者康复的影响。方法将我科2014年5月~2016年5月行手术治疗的原发性肝癌患者120例作为研究对象,运用欧洲营养风险筛查量表评估患者的营养状况(NRS-2002得分),运用吲哚氰绿排泄试验测定患者肝储备功能(ICGR15),并根据患者术前营养状态及肝储备功能分为A、B、C、D四组,观察四组患者术后康复指标的差异。结果当患者NRS-2002≥3时,肝储备功能欠佳的患者住院时间较长(P<0.05);ICGR15≥10%,营养状态越差,术后首次排气时间及拔除胃管时间越长(P<0.05);当患者NRS-2002≥3且ICGR15≥10%时,术后首次排气时间、拔除胃管时间、拔除腹腔引流管时间及住院时间更长(P<0.05)。结论术后恢复与患者术前的营养风险及肝储备功能相关,根据患者的肝储备功能及营养状态,术前积极采取营养支持及护肝治疗,改善患者营养状态及肝储备功能,以促进术后康复。Objective To assess the preoperative liver reserve function and the nutritional status in patients with liver cancer in order to study the impact on the postoperative recovery. Method 120 patients with liver cancer who received surgical treatment were divided into four groups by their liver reserve function（ICGR15） and the nutritional status（NRS-2002 evaluation scores）during 2014. 5-2016. 5 prospectively. And the preoperative liver reserve function were assessed by Indole cyanide green excretion test and the nutritional status were assessed by NRS-2002. Result When patient＇s NRS-2002≥3 ,the worse liver reserve function, the longer the hospital days（P〈0. 05）; When patient＇s ICGR15≥ 10%, the higher the NRS-2002 evaluation scores, the longer the time to remove the nasogastric tube and the first time of flatus（P^0. 05）~ And when patient＇s NRS-2002≥3 and ICGR15≥10%, the first time of flatus , and the time to remove nasogastric and drainage tube, and the hospital days were longer than other groups（P〈0. 05）. Conclusion Postoperative recovery was associated with preoperative nutritional risk and liver reserve function. According to the patient＇s liver reserve function and nutritional status, we should take treatment to protect patienfs liver and nutrition support in order to improve the postoperative recovery.

关 键 词：肝肿瘤 肝切除术 肝储备功能 

分 类 号：R735.7[医药卫生—肿瘤] R657.3[医药卫生—临床医学]