口服营养补充疗法对胃癌术后患者营养状态和生活质量的影响（23例随机对照临床观察）  

Effect of oral nutritional supplementation on nutritional status and quality of life in patients with gastric cancer after operation （23 cases RCT observations）

作　　者：崔红元[1] 杨鑫[1] 唐大年[1] 周新平[1] 丁润宇 朱明炜[1] 韦军民[1] Cui Hongyuan Yang Xin Tang Danian Zhou Xinping Ding Runyu Zhu Mingwei Wei Junmin(National Center of Gerontology, Department of General Surgery, Beifing Hospital, Belling 100730, China)

机构地区：[1]国家老年医学中心北京医院普外科,100730

出　　处：《中华临床营养杂志》2017年第3期183-188,共6页Chinese Journal of Clinical Nutrition

摘　　要：目的 探讨口服营养补充疗法对胃癌术后患者营养状态和生活质量的影响.方法 采用前瞻、单盲、随机、对照临床研究,纳入2015年6至8月北京医院25例在门诊接受新辅助化疗的胃癌术后患者,在饮食指导的基础上,研究组采用口服营养补充疗法,同时增加2 090 kJ/d的整蛋白型肠内营养剂,持续90 d,分别观察患者30、60、90 d时的体质量、体质量指数等人体测量指标,血红蛋白、前白蛋白、白蛋白等营养相关实验室指标,胃肠功能状况评分和生活质量评分等变化.结果 与术后出院时相比,研究组通过口服营养补充,60 d时体质量平均变化（0.66±1.47）kg,90 d时变化（-0.90±1.82）kg,与对照组[60 d：（-5.13±1.79）kg,90 d：（-9.56±2.44）kg]比较,差异均有统计学意义（P=0.027,P=0.015）;60 d时BMI变化（0.20±0.55）kg/m2,90 d时变化（-0.32±0.55）kg/m2,与对照组[60 d：（-2.06±0.67）kg/m2,90 d：（-3.21±0.73）kg/m2]比较,差异均有统计学意义（P=0.014,P=0.003）;两组其他人体测量指标和白蛋白、前白蛋白等实验室结果差异均无统计学意义（P均〉0.05）;胃肠功能状态和生活质量评分结果差异亦无统计学意义（P均〉0.05）.结论 口服营养补充疗法可减少胃癌患者术后化疗期间的体质量丢失,改善营养状态.Objective To investigate the effect of oral nutritional supplementation on the nutritional status and quality of life in patients with gastric cancer after operation.Methods In this prospective,single blind,randomized,controlled clinical study,25 postoperative patients with gastric cancer received neoadjuvant chemotherapy in outpatient clinic were enrolled.All patients received dietary guidance.In the intervention group,in addition to standard diet,oral nutritional supplements with 2 090 kJ/d of Intacted Protein Enteral Nutrition Powder were added,which lasted 90 days.The changes of body mass,body mass index（BMI）,hemoglobin,prealbumin,albumin,gastrointestinal function score,and life quality score 30,60,and 90 days after discharge were recorded.Patients on standard diets were used as the control group.Results In the intervention group,the body mass increased by（0.66 ±1.47）kg 60 d after discharge and（-0.90±1.82）kg on 90 d after discharge,which were [60 d：（-5.13±1.79）kg,90 d：（-9.56±2.44）kg] in the control group,and the difference was statistically significant（P=0.027,P=0.015）.The BMI of intervention group increased by（0.20 ±0.55）kg/m2 on 60 d and（-0.32±0.55）kg/m2 on 90 d after discharge,which were（-2.06±0.67）kg/m2 on 60d and（-3.21± 0.73）kg/m2 on 90 d in the control group（P=0.014,P=0.003）.There was no significant difference in terms of serum albumin,prealbumin and other laboratory indicators.Intestinal functional status and quality of life also showed no significant difference between these two groups.ConclusionOral nutrition supplementation can reduce the body mass loss and improve the nutritional status in patients with gastric cancer during chemotherapy after operation.

关 键 词：胃肿瘤 药物疗法 体质量 体质量指数 生活质量 口服营养补充 

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