Objective: To explore the intervention effect of perioperative parenteral nutrition on postoperative nutritional status in patients with gastrointestinal malignant tumors. Methods: 84 patients with gastrointestinal malignant tumor had been divided into experimental group and control group according to random number table, 42 cases of experimental group, 42 cases of control group. The patients in the experimental group had been given parenteral nutrition from 7th day pre-operation, at the same time, the patients in the control group had been given glucose-electrolyte solution routinely; both two groups had been given equal nitrogen amount and isocaloric parenteral nutrition from 1th day postoperation, and then indicators of 1th day and 7th day after operation were observed.Results: At l day pre-operation, the body mass index, blood prealbumin and transferrin in the experimental group were higher than those in the control group, the differences were statistically significant (P<0.05). At 7 days after operation, the body mass index, triceps skinfold, blood albumin, hemoglobin, prealbumin and transferrin values in the experimental group were higher than those in the control group, the pulmonary infection incidence rate was lower in the experimental group than that in the control group, the differences had statistical significances (P<0.05). Conclusion: In gastrointestinal malignant tumor patients with nutritional risk, preoperative parenteral nutrition therapy can effectively improve nutritional status and reduce incidence rate of pulmonary infection after operation. |
[1] 崔丽英,陈海波,宿英英,等.北京大医院神经科住院患者营养风险、营养不足、超重和肥胖发生率及营养支持应用状况[J].中华临床营养杂志,2009,20(2):67-70.
[2] 顾景范,杜寿玢,郭长江.现代临床营养学[M].北京:科学出版社,2009:36-37.
[3] BRAGA M L,JUNGQVIST O,SOETER P,et a1.ESPEN guidelines on parenteral nutrition:surgery[J].Clin Nutr,2009,28(4):378-386.
[4] CURI R,LAGRANHA C J,DOI S Q,et al.Molecular mechanisms of glutamine action[J].J Cell Physiol,2005,204(2):392-401.
[5] SCHWEGLER I,von HOLZEN A,GUTZWILHR J P,et al.Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer[J].Br J Surg,2010,97(10):92-97.
[6] RYU S W,KIM I H.Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients[J].World J Gastroenterol,2010,16(26):3310-3317.
[7] MOYNAGH P.Postoperative starvation after gastrointestina surgery[J].BMJ,2002,324(7335):481.
[8] 陈满宇,吕龙,何秋山.胃肠道恶性肿瘤患者营养状况评价及影响因素分析[J].东南大学学报:医学版,2016,35(2):208-211.
[9] VELASCO C,GARDA E,RODRTGUEZ V,et al.Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients:a muhiccntre study[J].Eur J Clin Nutr,201l,65(2):269-274.
[10] 赵自然,康维明,于健春.消化道肿瘤患者营养支持治疗[J].临床药物治疗杂志,2013,11 (4):9-13.
[11] 于健春.胃肠外科患者营养状况评估与营养支持途径的选择[J].中华胃肠外科杂志,2012,15(5):429-432.
[12] 金吉安,于翠敏.胃肠道肿瘤患者围手术期肠外营养支持的观察[J].中国医药指南,2015,13(17):183.
[13] 卜君,黄雄,李念.术前营养支持对于减少存在营养不良的胃癌患者术后呼吸系统并发症的作用[J].实用医学杂志,2013,29(8):1246-1248.
[14] 李燕,程垚,徐斌,等.食管癌患者术前营养风险评估与干预的效果评价[J].中华护理杂志,2015,50(2):166-170. |