原发性肝癌患者体液变化的研究  

The study on changes of body fluid in patients with primary liver cancer

作　　者：刘欣 李丽 LIU Xin;LI Li(Department of Nutriology,the 983th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Tianjin 300142,China)

机构地区：[1]联勤保障部队第九八三医院营养科,天津300142

出　　处：《天津医药》2021年第7期756-759,共4页Tianjin Medical Journal

摘　　要：目的观察原发性肝癌患者体液分布变化,为患者的营养评价提供依据。方法选择原发性肝癌患者80例,根据肝功能Child-Pugh分级分为A、B、C组;24例健康体检者作为正常对照(N)组,用生物电阻抗分析法测定人体全身水量(TBW)、细胞外水分(ECW)、细胞内水分(ICW)、浮肿指数(ECW/TBW)、身体细胞量(BCM)。结果原发性肝癌患者中ICW和BCM不足均占37.5%(30/80),ECW异常者占42.5%(34/80);出现水肿(ECW/TBW>0.39)者占85%(68/80)。B组和C组水肿患者比例明显高于A组(P<0.05),其中C组全部患者出现水肿情况;ICW、BCM异常比例随肝功能分级增加而升高(P<0.05)。C组经过理想体质量(SW)校正后的细胞内水分含量(ICW/SW)低于其他各组(P<0.05)。各病例组ECW/实际体质量(BW)、ECW/TBW高于N组(P<0.05),病例组各组之间差异无统计学意义(P>0.05)。各病例组患者ICW、ECW、SW校正后的ECW(ECW/SW)、BCM与N组比较差异无统计学意义(P>0.05)。结论原发性肝癌患者功能细胞数量进行性消耗,普遍存在细胞内外水分分布异常,应尽早进行合理营养治疗。Objective To observe the changes of body fluid distribution in patients with primary liver cancer(PLC)and to provide the basis for nutritional evaluation of PLC patients.Methods Eighty patients with PLC were divided into group A,group B and group C according to the Child-Pugh classification of liver function.Twenty-four healthy people were included as normal control group(group N).The total body water(TBW),extracellular water(ECW),intracellular water(ICW),edema index(ECW/TBW)and body cell mass(BCM)were measured by bioelectrical impedance method.Results In PLC patients,ICW and BCM insufficiency accounted for 37.5%(30/80),ECW abnormality accounted for 42.5%(34/80),and edema(ECW/TBW>0.39)accounted for 85%(68/80).The proportion of edema patients was significantly higher in group B and group C than that in group A(P<0.05).All patients in group C showed edema.The proportion of patients with abnormal ICW and BCM increased with the deterioration of liver function(P<0.05).The content of intracellular water adjusted by ideal weight was significantly lower in group C than that of the control group(P<0.05).There was no significant difference in ECW/BW and ECW/TBW between the case groups(P>0.05),but which were higher in the case groups than that of the normal control group(P<0.05).There were no significant differences in ICW,ECW,ECW/SW and BCM between the case groups and the normal control group(P>0.05).Conclusion The number of functional cells is gradually consumed in patients with primary liver cancer,and the abnormal distribution of intracellular and extracellular water in body is common,leading to the increase of edema index.It is suggested that rational nutrition therapy should be carried out as soon as possible.

关 键 词：癌 肝细胞 电阻抗 生物细胞内水分 细胞外水分 身体细胞量 

分 类 号：R735.7[医药卫生—肿瘤]