不同营养治疗对肺癌术后乳糜胸的临床结局对比分析  

Clinical outcomes of the postoperative lung cancer with chylothorax receiving different nutritional treatments:a comparative study

作　　者：刘欢 胡雯[1,3] 程懿[3] 赵义熙 Liu Huan;Hu Wen;Cheng Yi;Zhao Yixi(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Department of Clinical Nutrition,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;Department of Clinical Nutrition,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Thoracic Surgery,Mianyang Central Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,成都610041 [2]绵阳市中心医院临床营养科,四川绵阳621000 [3]四川大学华西医院临床营养科,成都610041 [4]绵阳市中心医院胸心外科,四川绵阳621000

出　　处：《肿瘤代谢与营养电子杂志》2021年第4期420-423,共4页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：四川省科技计划项目(2019YJ0042)。

摘　　要：目的探讨3种不同营养治疗对肺癌术后乳糜胸患者的临床结局。方法将入选的45例患者随机分为三组:全肠外营养(TPN)组、中链甘油三酯饮食(MCT)组和低脂饮食(LF)组,每组各15例。患者确诊乳糜胸后进行相应营养治疗。分析三组患者的白蛋白水平、胸腔引流量、主观舒适度、拔管时间及营养费用等指标。结果三组患者诊断乳糜胸时白蛋白水平均较入院时显著下降(P<0.05),经过营养治疗后,三组患者出院时白蛋白水平均较诊断时明显升高,差异有统计学意义(P<0.05);营养治疗第7天时三组患者主观舒适度评分均较诊断乳糜胸时降低(P<0.05),其中,TPN组主观舒适度评分最高,其次是LF组,最后是MCT组。两两比较差异均有统计学意义(P<0.05);营养治疗7 d后三组胸腔引流量、拔管时间和结扎手术率差异均无统计学意义(P>0.05),但MCT组和LF组营养治疗费用和诊断后住院时间均显著短于TPN组(P<0.05)。结论肺癌术后乳糜胸患者应首选添加MCT饮食作为营养治疗方式。Objective To observe the clinical outcomes of three different nutritional treatments for the postoperative lung cancer with chylothorax patients,and to provide reference for future clinical treatment.Methods According to the inclusion and exclusion criteria,45 patients were randomly divided into 3 groups:total parenteral nutrition(TPN)group,medium-chain triglyceride(MCT)diet group and low-fat(LF)diet group,with 15 patients in each group.After diagnosis of chylothorax,the patient immediately received nutritional treatment.Results Albumin levels of patients in the three groups were significantly lower at the time of diagnosis of chylothorax than at the time of admission(P<0.05).After nutritional treatment,albumin levels of patients in the three groups were significantly higher at the time of discharge than at the time of diagnosis,and the difference was statistically significant(P<0.05).The subjective comfort scores after 7 days nutritional treatment of the three groups were lower than that at the time of diagnosis of chylothorax(P<0.05),and the subjective comfort score of the TPN group was highest,followed by the LF group and TPN group in turn,with obvious difference between mutual groups(P<0.05).The amount of chest drainage after 7 days of nutritional treatment,the time to removal of drainage tube and ligation rate were no significant in the three groups(P>0.05).But the cost of nutritional treatment and the length of hospital stay after diagnosis in the MCT group and LF group were significantly lower than those in the TPN group(P<0.05).Conclusion The diet supplemented with MCT should be the first choice of nutritional treatment for the postoperative lung cancer with chylothorax patients.

关 键 词：肺癌 乳糜胸 营养治疗 

分 类 号：R734.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]