长链脂肪乳对低位直肠癌患者围术期营养状况的影响  

Effect of long-chain fat emulsion on perioperative nutritional status of patients with low rectal cancer

作　　者：李尚 任崇仁[1] 赵浩亮[1] 常冰梅[2] 杨川丽 王晋喜[1] Li Shang;Ren Chongren;Zhao Haoliang;Chang Bingmei;Yang Chuanli;Wang Jinxi(Department of General Surgery,the Third Hospital of Shanxi Medical University,Taiyuan 030032,China;Department of Biochemistry and Molecular Biology,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第三医院普通外科,太原030032 [2]山西医科大学生物化学与分子生物学教研室,太原030001

出　　处：《肿瘤研究与临床》2021年第8期618-622,共5页Cancer Research and Clinic

基　　金：山西省重点研发计划(201903D321101);山西省卫生健康委员会课题(2020005)。

摘　　要：目的探讨肠外营养治疗中使用长链脂肪乳剂对低位直肠癌患者围术期营养状况的影响。方法回顾性分析山西医科大学第三医院2017年1月至2020年6月204例行直肠癌手术治疗患者的临床资料。按照具体营养治疗方式分为两组,研究组100例使用长链脂肪乳剂进行肠外营养支持,对照组104例使用中/长链脂肪乳注射液。入院后根据患者主观整体营养状况评估量表(PG-SGA)及相关实验室检查结果对患者进行营养状况评估,术前第7天开始对患者进行营养及电解质支持治疗,术后采取肠外营养与肠内营养联合治疗及早期肠内营养的方式。记录并对比两组患者术前第7天、术后第1天、术后第7天的清蛋白、前清蛋白、视黄醇结合蛋白、总胆固醇、体质量指数(BMI)以及术后首次排气时间、术后并发症发生情况、术后发热情况和总住院时间。结果研究组术后首次排气时间[(42±11)h比(54±10)h]、发热时间[(48±8)h比(57±7)h]、总住院时间[(16.0±0.7)d比(18.0±0.9)d]、术后第7天静息能量消耗[(5326±589)kJ/d比(5840±599)kJ/d]以及术后第7天总胆固醇[(4.8±0.3)mmol/L比(5.0±0.4)mmol/L]均低于对照组,研究组术后第7天清蛋白[(33±3)g/L比(28±3)g/L]、前清蛋白[(0.189±0.041)g/L比(0.164±0.037)g/L]及视黄醇结合蛋白[(0.039±0.016)g/L比(0.032±0.013)g/L]均高于对照组,两组差异均有统计学意义(均P<0.05)。其他检测指标两组差异均无统计学意义(均P>0.05)。结论围术期存在营养不良的低位直肠癌患者使用长链脂肪乳剂可能更有利于机体恢复。Objective To explore the effect of long-chain fat emulsion in parenteral nutrition therapy on the perioperative nutritional status of patients with low rectal cancer.Methods A total of 204 patients who underwent rectal cancer surgery in the Third Hospital of Shanxi Medical University from January 2017 to June 2020 were retrospectively analyzed.The patients were divided into two groups according to the specific nutritional treatment methods,100 cases in the study group used long-chain fat emulsion for parenteral nutrition support,and 104 cases in the control group used medium-and long-chain fat emulsion injection.After admission,the nutritional status of patients were evaluated according to the results of Scored Patient-Generated Subjective Global Assessment(PG-SGA)and related laboratory tests.At 7th day before the operation,the patients were treated with nutrition and electrolyte support.Parenteral nutrition and enteral nutrition combined treatment and early enteral nutrition were given after the operation.The albumin,prealbumin,retinol-binding protein,total cholesterol and body mass index(BMI)at 7th day before the operation,1st day after the operation and 7th day after the operation and the patient's first exhaust time after surgery,occurrence of postoperative complications,postoperative fever and total hospital stay were recorded and compared between the two groups.Results Postoperative first exhaust time[(42±11)h vs.(54±10)h],fever time[(48±8)h vs.(57±7)h],total hospital stay[(16.0±0.7)d vs.(18.0±0.9)d],resting energy expenditure at the 7th day after surgery[(5326±589)kJ/d vs.(5840±599)kJ/d]and total cholesterol at the 7th day after surgery[(4.8±0.3)mmol/L vs.(5.0±0.4)mmol/L]in the study group were lower than those in the control group,and albumin[(33±3)g/L vs.(28±3)g/L],prealbumin[(0.189±0.041)g/L vs.(0.164±0.037)g/L]and retinol-binding protein[(0.039±0.016)g/L vs.(0.032±0.013)g/L]at the 7th day after surgery in the study group were higher than those in the control group,and the differences be

关 键 词：直肠肿瘤 胃肠外营养 脂肪乳剂 静脉注射用 围术期 

分 类 号：R735.37[医药卫生—肿瘤] R459.3[医药卫生—临床医学]