| 肠内肠外联合营养支持治疗肝细胞癌患者围术期临床研究* |
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| 引用本文： | 王朝霞,关珂,付三仙,王慧杰. 肠内肠外联合营养支持治疗肝细胞癌患者围术期临床研究*[J]. 实用肝脏病杂志, 2019, 22(2): 272-275. DOI: 10.3969/j.issn.1672-5069.2019.02.030 |
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| 作者姓名： | 王朝霞 关珂 付三仙 王慧杰 |
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| 作者单位： | 471000 河南省洛阳市 郑州大学附属洛阳中心医院营养科（王朝霞）;中西医结合肿瘤科（王慧杰）;第一附属医院营养科（付三仙）;河南省人民医院营养科（关珂） |
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| 摘 要： | 目的 探讨采用肠内肠外联合营养支持对于肝细胞癌（HCC）患者肝叶切除术围手术期的影响。方法 2015年1月~2017年12月在本院行肝叶切除术治疗的HCC患者130例, 在术后根据营养支持方案的不同分为对照组65例和试验组65例, 分别给予肠外营养支持和肠内肠外联合营养支持, 观察术后恢复情况。结果 术后2w, 观察组患者血清白蛋白水平为（41.4±2.9）g/L, 前白蛋白水平为（260.8±12.5）mg/L, Child-Pugh评分为（5.7±1.7）, 与对照组的（34.6±2.5）g/L、（233.3±2.4）mg/L和（6.6±1.5）比, 差异显著（P<0.05）;两组肝功能指标比较, 无显著性差异（P>0.05）;术后, 试验组排便时间为（3.3±1.5）d, 显著早于对照组的【（4.3±1.2）d, P<0.05】, 但住院花费为（53696.3±16754.4）元, 显著多于对照组的（50780.6±13632.7）元（P<0.05）;试验组术后胆瘘、感染和肝功能不全发生率为26.2%, 与对照组的32.2%比, 差异无统计学意义（P>0.05）。结论 在HCC患者接受肝叶切除术的围术期, 采用肠内肠外联合营养支持治疗可以早期促进胃肠运动, 加速康复, 有利于术后恢复。
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| 关 键 词： | 肝细胞癌 肠内营养 肠外营养 围手术期 |
| 收稿时间： | 2018-07-20 |
Early administration of enteral nutrition in patients with hepatocellular carcinoma undergoing hepatectomy |
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| Wang Zhaoxia,Guan Ke,Fu Sanxian,Wang Huijie. Early administration of enteral nutrition in patients with hepatocellular carcinoma undergoing hepatectomy[J]. Journal of Clinical Hepatology, 2019, 22(2): 272-275. DOI: 10.3969/j.issn.1672-5069.2019.02.030 |
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| Authors: | Wang Zhaoxia Guan Ke Fu Sanxian Wang Huijie |
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| Affiliation: | Department of Nutrition, Central Hospital Affiliated to Zhengzhou University, Luoyang471000,Henan Province, China |
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| Abstract: | Objective The study was conducted to assess the efficacy of early administration of enteral nutrition （EN） in patients with hepatocellular carcinoma （HCC） undergoing hepatectomy. Methods A retrospective study was conducted in 130 HCC patients who undergoing surgical resection of hepatic tumor in our hospital between January 2015 and December 2017,and the diagnosis of HCC was approved by post-operational pathological examination. After hepatectomy,65 patients in observation received parenteral nutrition（PN） and EN,and another 65 in control received PN. Results At the end of two weeks after operation,serum albumin level in the observation was （41.4±2.9） g/L,prealbumin level was （260.8±12.5） mg/L,and Child-Pugh score was （5.7±1.7）,significantly different as compared to [（34.6±2.5） g/L,（233.3±2.4） mg/L and（6.6±1.5）,P<0.05] in the control;there were no significant differences in the blood liver tests between the two groups（P>0.05）;after operation,the excrement was（3.3±1.5）d,much earlier than 【（4.3±1.2）d,P<0.05】,while the hospitalization fee was（53696.3±16754.4） yuan,significantly higher than （50780.6±13632.7）yuan （P<0.05） in the control;the biliary leakage,infection,and liver insufficiency in observation group was 26.2%,no significantly different as compared to 32.2% in the control（P>0.05）. Conclusion Early administration of EN and PN combination in patients with HCC undergoing hepatectomy might elevate blood albumin levels,reduce post-operational complications and improve rehabilitation. |
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| Keywords: | Hepatocellular carcinoma Enteral nutrition Parenteral nutrition Perioperative period |
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