短期全肠外营养支持对合并营养不良的胃肠道肿瘤患者的作用

目的：研究全肠外营养支持对合并营养不良的胃肠道肿瘤患者营养状态、术后并发症和住院时间的作用。方法：对2009年1月～2010年6月收治的80例合并营养不良的胃癌或结直肠癌患者的临床资料进行分析,其中,男性47例,女性33例,平均年龄（51.5±7.3）岁（36～75岁）。所有入组患者均接受肿瘤切除治疗,随机分为两组,对照组（不给予营养支持）和肠外营养组（术前3d和术后5d均给予全肠外营养支持）。分别检测对照组和营养支持组术前（入院第1天）和术后（术后第5天）人体测量学指标和实验室指标,同时监测术后并发症和预后。结果：对照组和营养支持组无论术前还是术后人体测量学指标之间没有显著差异,营养支持组人体测量学指标轻微下降;术后营养支持组清蛋白、前清蛋白和淋巴细胞计数较对照组有显著增加,但是和术前相比差异无统计学意义;同时,营养支持组术后并发症发生率低于对照组,术后出院时间比对照组显著缩短。结论：胃肠道肿瘤患者术前和术后给予短期全肠外营养支持可以改善机体的营养状态,减少外科手术风险和术后并发症的发生率,缩短住院时间,促进患者的恢复。

The role of short-term total parenteral nutrition in malnourished gastrointestinal cancer patients

Objective：To evaluate the effect of total parenteral nutrition （TPN） for nutritional status,postoperative complications and the duration of hospitalisation in gastrointestinal cancer patients with malnutrition.Methods：Analyzed the clinical information of eighty （forty seven male and thirty three female） gastric cancer or colorectal cancer patients with malnutrition from January 2009 to June 2010.The average age was （51.5±7.3） years （36-75 years）.These patients who accepted surgery therapy were randomly divided into control group （no nutrition support） and TPN group （given total parenteral nutrition from preoperation three days to postoperation five days）.Anthropometry index,laboratory index,postoperative complications and prognosis were detected before （the admission） and after （the postoperatin five days） operation in both groups.Results：Although there was slightly decent with regard to anthropometry index in TPN group,there was no significant difference between control group and TPN group whether preoperation or postoperation.The serum albumin,prealbumin and lymphocyte count in TPN group were higher than control group,while these indexes were not statistically significant in TPN group between pre-and post-operation.And also the postoperative complications and the length of hospitalization were notable shorter in TPN group.Conclusion：Perioperative and postoperative total parenteral nutrition in malnourished gastrointestinal cancer patients would improve nutrition status,reduce the surgical risk and postoperative complications rate,shorten hospital stay,and promote the recovery of patients.