造血干细胞移植患者术后营养方案的评价

目的比较不同营养支持方案下造血干细胞移植患者术后的营养状况改变和用于营养支持方面的费用支出,以对营养方案进行评价。方法47例进行造血干细胞移植的患者,随机分为完全肠外营养（total parenteralnutrition,TPN）支持组、肠内营养（enteral nutrition,EN）支持组、经口饮食（oral diet,OD）组。分别于移植后的0、7、14d用“测定人体组成的营养评价方法（body composition assessment,BCA）”评价患者的营养状况。记录各组患者在观察期内的用于营养支持的费用支出。结果47例患者在移植后7 d,TPN组27.00%出现中、重度营养不良;EN组20.00%出现中、重度营养不良;OD组11.76%出现中、重度营养不良。14 d时,TPN组40.00%出现中、重度营养不良;EN组26.67%出现中、重度营养不良;OD组17.65%出现中、重度营养不良。患者滞留层流病房期间用于营养支持方面的费用支出,TPN组〉EN组〉OD组（P〈0.05）。结论造血干细胞移植术后患者属于营养不良状况,并且随着滞留层流病房时间的延长,营养不良状况加重。加重的程度OD组最慢。患者用于营养支持的费用支出OD组最低。

Evaluation of nutrition support schemes on hematopoietic stem cell transplantation recipients

Objective To compare the nutritional state and the cost of three nutrition support schemes for hematopoietic stem cell transplantation(HBSCT) recipients to find a most suitable way for these patients.Methods Forty-seven HBSCT recipients were randomly divided into total parenteral nutrition(TPN) group,enteral nutrition(EN) group and oral diet(OD) group.The nutrition situation were evaluated by Body Composition Assessment(BCA) on 0th,7th and 14th days,and the expense was calculated respectively on the nutrition support schemes.Results After 7 days,27.00% of the patients were suffered from middling or severe malnutrition in TPN group,20.00% in EN group while 11.76%in OD group.After 14 days,40.00% patients in TPN group,26.67% patients in EN group and 17.65% patients in OD group were suffered from middling or severe malnutrition.While the average expense in TPN group was larger than that in EN group,and the average expense in EN group was larger than that in OD group(P<0.05).Conclusion The OD scheme is better than EN,and EN is better than TPN for HSCT recipients' nutritional support.