基于预后营养指数的分级营养干预对胃癌根治性手术患者的应用效果  

Effect of graded nutritional intervention based on prognostic nutritional index in patients with gastric cancer undergoing radical surgery

作　　者：张婉秋 李海燕[1] Zhang Wanqiu;Li Haiyan(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《肿瘤综合治疗电子杂志》2023年第2期146-150,共5页Journal of Multidisciplinary Cancer Management(Electronic Version)

摘　　要：目的 探讨基于预后营养指数(prognostic nutritional index,PNI)的分级营养干预对胃癌根治性手术患者的应用效果。方法 本研究属于一项前瞻性临床对照研究,将2019年6月至2022年5月首都医科大学附属北京友谊医院收治的92例拟行胃癌根治术的患者通过随机数字表法分为干预组与对照组,每组各46例,在围手术期分别予常规营养干预和基于PNI的分级营养干预,比较两组患者手术前后的PNI、营养状况、免疫功能、术后恢复状况及并发症。结果 与组内入院时比较,干预组患者术前第1天、术后第7天的PNI、血前白蛋白(prealbumin,PA)、转铁蛋白(transferrin,TRF)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)、免疫球蛋白A(immunoglobulin A,IgA)水平均显著升高(均P <0.05),而对照组患者术前第1天、术后第7天的PNI、血PA、TRF、IgG、IgM、IgA水平较入院时的水平均无明显变化(均P> 0.05)。与对照组同期比较,干预组患者术前第1天、术后第7天的PNI、血PA、TRF、IgG、IgM、IgA水平均显著升高(均P <0.05)。干预组患者实际能量摄入量显著大于对照组(P <0.05),术后首次排气时间、肠内营养开始治疗时间均显著早于对照组(均P <0.05),术后住院天数显著短于对照组(P <0.05)。两组患者并发症总发生率比较差异无统计学意义(P> 0.05)。结论基于PNI的营养干预能有效改善胃癌根治性手术患者的营养状况和免疫功能,促进术后康复。Objective To investigate the effect of graded nutritional intervention based on prognostic nutritional index(PNI)in patients with gastric cancer undergoing radical surgery.Method This study is a prospective clinical symptomatic study.Ninety-two patients with gastric cancer who were admitted to Beijing Friendship Hospital,Capital Medical University from June 2019 to May 2022 were divided into control group and intervention group by the random number table method,with 46 cases in each group,which were given routine nutrition intervention and graded nutrition intervention based on PNI during the perioperative period respectively.PNI,nutritional status,immune function,postoperative recovery status and complications between the two groups were compared before and after operation.Result Compared with the level at admission,the PNI,blood levels of prealbumin(PA),transferrin(TRF),immunoglobulin G(IgG),immunoglobulin M(IgM)and immunoglobulin A(IgA)of patients at the first day before operation and the seventh day after operation in observation group were significantly increased(all P<0.05),while PNI,blood levels of PA,TRF,IgG,IgM and IgA in control group did not change significantly at the first day before operation and the seventh day after operation compared to the level at admission(all P>0.05).Compared with control group at the same time,PNI,blood levels of PA,TRF,IgG,IgM and IgA at the first day before operation and the seventh day after operation in observation group were significantly increased(all P<0.05).The actual input of nutrient energy in observation group was significantly higher than that in control group(P<0.05),and the first exhaust time,start time of enteral nutrition treatment were significantly earlier than those in control group(all P<0.05),and the postoperative hospital days were significantly shorter than those in control group(all P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Nutritional intervention based on PNI can eff

关 键 词：胃癌 预后营养指数 分级营养干预 免疫功能 术后康复 

分 类 号：R735.2[医药卫生—肿瘤]