优化营养支持手段与单纯肠外营养对老年肝癌切除患者术后临床结局的影响

目的评价优化营养支持手段对老年肝癌切除患者改善临床结局的意义。方法对我院2007至2009年（研究组52例）接受肝癌切除手术老年患者采用优化营养支持的手段，包括住院后进行营养风险筛查，评分≥3分给予营养支持、术前1～3d肠内营养（EN）口服补充、术后肠外营养（PN）联合EN支持等，并与2005至2007年（对照组30例）同类手术后单纯接受PN的老年患者比较，观察术后营养指标变化、术后住院时间、总住院费用和并发症的发生率。结果两组术后第7天体重、蛋白水平变化相似（P〉0．05）；研究组感染并发症发生率及住院时间显著低于对照组（P〈0．05）。结论老年患者接受肝癌切除手术，应先进行营养风险筛查，围手术期优化营养支持手段能够改善临床结局。

Influences of optimization of nutritional support and parenteral nutrition in elderly patients after hepatic carcinoma surgery on clinical outcomes

Objective To summarize the clinical outcomes after the optimization of nutrition support in elderly patients after hepatic carcinoma surgery.Methods The clinical data of 52 elderly patients with hepatic carcinoma in Beijing Hospital were collected and analyzed from 2007 to 2009(research group).Nutritional Risk Screening(NRS)2002 was applied for the nutrition risk screening at admission.NRS 2002 score≥3 was regarded as at nutritional risk.Enteral nutrition(EN)or EN combined with parentoral nutrition(EN+PN)supports were provided during the peri-operative stage.The control group included 30 patients from 2005-2007 under the same conditions with rescareh group but only received PN supports pest-operatively.Nutritional parameters,complications,lengh of hospital stay,and healthcare expenditures were analyzed.Results Body weight and plasma albumin were no significantly different in two groups(P>0.05)by the 7th post-operative day.The incidence of infection-relatod complications and length of hospital stay were significantly lower in research group than in control group (P<0.05).Conclusions Nutrition risk screening should be performed for the elderly patients with hepatic carcinoma after admission.Optimization of peri-operative nutrition support can reduce complications and improve the clinical outcomes.