胃肠道恶性肿瘤患者围手术期肠外营养的治疗效果-东南大学学报医学版

胃肠道恶性肿瘤患者围手术期肠外营养的治疗效果

单位：1. 承德医学院附属医院营养科, 河北承德 067000;
2. 承德医学院附属医院静脉用药调配中心, 河北承德 067000;
3. 承德医学院附属医院介入中心, 河北承德 067000;
4. 承德医学院附属医院内分泌科, 河北承德 067000;
5. 承德市中心医院放化疗中心, 河北承德 0

关键词：胃肠道恶性肿瘤围手术期肠外营养体重指数白蛋白前白蛋白

分类号：R735.2;R735.3

出版年·卷·期（页码）：2017·36·第二期（213-216）

摘要：

目的：探讨围手术期肠外营养对胃肠道恶性肿瘤患者术后营养状况的干预效果。方法：胃肠道恶性肿瘤患者84例，按随机数字表法随机分为实验组与对照组，每组各42例。实验组术前7 d开始给予肠外营养，对照组常规给予糖电解质输液；两组患者均于术后第1天开始给予等氮等热量的肠外营养治疗，观察两组患者术前1 d、术后7 d各项指标的变化。结果：实验组患者术前1 d的体重指数（body mass index，BMI）值、血清前白蛋白（prealbumin，PA）和转铁蛋白（transferrin，TF）值均高于对照组，差异有统计学意义（P<0.05）。术后7 d，实验组患者的BMI、肱三头肌皮褶厚度（triceps skinfold thickness，TSF）值、血白蛋白（albumin，ALB）、血红蛋白（hemoglobin，HGB）、PA和TF值均高于对照组，实验组肺部感染发生率低于对照组，差异均有统计学意义（P<0.05）。结论：存在营养风险的胃肠道恶性肿瘤患者术前给予肠外营养治疗可有效改善患者术后的营养状况，降低术后肺部感染发生率。

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.

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