术前预康复对食管癌病人术后营养状况与人体体成分的影响  

The effect of preoperative prehabilitation on nutritional status and body composition of patients with esophageal cancer after operation

作　　者：郭仲 冀赛光 徐杨 丛壮壮[2] 胡力文[2] 申翼[1,2] GUO Zhong;JI Sai-guang;XU Yang;CONG Zhuang-zhuang;HU Li-wen;SHEN Yi(Department of Cardiothoraeic Surgery, Jinling Hospital, Southern Medical University, Nanjing 210002, Jiangsu, China;Department of Cardiothoracic Surgery, Nanjing General Hospital of Nanjing Military Region, Nanjing 210002, Jiangsu, China)

机构地区：[1]南方医科大学附属金陵医院南京军区南京总医院,江苏南京210002 [2]南京军区南京总医院心胸外科,江苏南京210002

出　　处：《肠外与肠内营养》2018年第3期156-160,共5页Parenteral & Enteral Nutrition

基　　金：江苏省自然科学基金(BK20160606)

摘　　要：目的:探讨术前预康复手段对于食管癌病人术后营养状况以及人体体成分的影响。方法:前瞻性选取收治于我院胸外科100例食管癌病人随机分为实验组A组与对照组B组各50例。实验组在门诊收治当日开始预康复干预,对照组给予常规食管癌术前准备。分别测量食管癌病人收治当天以及术后(1、3、7、30天)的白蛋白、前白蛋白、血清转铁蛋白水平,记录两组病人术后相关情况(白蛋白补充量、术后并发症发生率、ICU监护时间、住院总花费),同时利用生物电阻抗法(BIA)测量食管癌病人收治当天及术后7天,术后30天人体体成分。结果:两组病人术前营养状况指标白蛋白、前白蛋白、血清转铁蛋白与人体体成分各项指标均无统计学差异。术后第1、3、7、30天实验组前白蛋白水平明显高于对照组,术后第3、7、30天实验组白蛋白、转铁蛋白水平也显著高于对照组。术后第7天实验组人体体成分各项指标变化与对照组无统计学差异,但在术后30天实验组人体体成分指标骨骼肌、体水分、细胞内水分、蛋白质、身体细胞量丢失程度明显少于对照组。预康复组的术后并发症发生率,ICU监护时间及住院总费用均明显少于对照组。结论:术前预康复干预可明显改善食管癌病人术后营养状况与食管癌病人预后,同时可减轻人体体成分丢失。Objective： To observe the efficacy of preoperative prehabilitation on nutritional status and body composition of patients with esophageal cancer after operation. Methods： A total of 100 patients with esophageal cancer were randomly divided into the study group A and the control group B. The study group received prehabilitation from the day they adimitted to hospital and the control group received common preoperative preparation. The preoperative baseline data and postoperative indicators including levels of serum albumin, prealbumin, transferrin were recorded the day admitted to hospital and the 1,3,7,30 th day after surgery. Record the prognosis of the patients（albumin supplementation, incidence of postoperative complications, ICU monitoring time, total cost of hospitalization）. And the body composition was examined on the day admitted to hospital and the 7,30 th day after surgery with BIA. Results： The level of serum albumin, prealbumin, transferrin and body composition were no statistically significant difference between the study group and the control group. Compared with the control group, the level of prealbumin were significantly higher in the study group on the 1, 3, 7, 30 th day after surgery. The level of serum albumin, transferrin were also significantly higher in study group on the 3, 7, 30 th day after surgery. The body composition was no significant difference between the two groups on the 7 th day postoperatively. However, the loss of body composition such as skeletal muscle, body water, intracellular water, protein level and body cell volume were less in the study group compared with the control group on the 30 th day after surgery. The incidence of postoperative complications in the prehabilitation group, ICU monitoring time, and hospitalization costs were significantly less than those in the control group. Conclusion： Prehabilitation intervention can obviously improve the nutritional status and the prognosis of the patients with esophageal cancer, and reduce the loss degree of their

关 键 词：术前预康复 食管癌 人体成分分析 营养状况 

分 类 号：R735.1[医药卫生—肿瘤]