补充性肠外营养在加速康复外科肝癌患者术后的应用  

Supplemental parenteral nutrition in enhanced recovery in postoperative liver cancer patients

作　　者：张坤[1] 朱锦德[1] 吕昕亮[1] 涂朝勇[1] 姜川[1] 林巧妹[1] 李卓锴[1] 周擎云 邵初晓[1] Zhang Kim;Zhu Jingde;Lyu Xinliang;Tu Chao-yong;Jiang Chuan;Lin Qiaomei;Li Zhuokai;Zhou Qingyun;Shao Chuxiao(Department of Hepatobiliary Surgery , Lishui Municipal Central Hospital, Lishui 323000, China)

机构地区：[1]丽水市中心医院肝胆胰外科,浙江省丽水323000

出　　处：《中华普通外科杂志》2019年第8期693-695,共3页Chinese Journal of General Surgery

基　　金：丽水市重点研发计划项i(2016zdyf01);浙江省中医药科技计划项目(2018ZB142).

摘　　要：目的探讨实施加速康复外科肝癌术后患者应用补充性肠外营养(supplemental parenteral nutrition,SPN)联合早期肠内营养(enteral nutrition ,EN)的效果。方法选取2015年6月至2018年6月诊治的92例肝癌患者,随机分为2组,术后SPN联合早期EN支持的患者为研究组47例,单纯早期EN营养支持的患者为对照组45例,比较两组患者术后恢复情况。结果术后胆红素恢复、肝酶恢复、术后排气排便时间和并发症率等比较,差异无统计学意义(P > 0. 05)。相比对照组,研究组前白蛋白水平恢复更快(F组间=7. 89,P = 0.006),白蛋白用量更少(t=-2.29,P =0.0024),术后住院时间更短(t= 2.46,P = 0.016)。结论对ERAS肝癌术后患者,SPN联合早期EN能兼顾肠内营养支持的优势,提供合理的能量支持,改善营养状况,加速患者康复。Objective To explore the effect of supplemental parenteral nutrition ( SPN) combined with early enteral nutrition ( EN ) for enhanced recovery in postoperative liver cancer patients. Methods From June 2015 to June 2018, liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group. Results There were no significant difference in bilirubin recovery, liver enzyme recovery, postoperative exhaust and defecation time and complication rate between the two groups (P > 0. 05 ). In study group prealbumin ( PAB) synthesis recovered faster ( F = 7. 89, P =0. 006), albumin use was significantly lower ( t =- 2. 29, P = 0. 0024), and postoperative hospital stay was shorter ( t = 2. 46, P =0. 016). Conclusion In ERAS patients with liver cancer, the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.

关 键 词：癌 肝细胞 胃肠外营养 肠道营养 

分 类 号：R735.7[医药卫生—肿瘤]