胃癌患者围手术期营养支持评估

目的 评估营养支持在胃癌患者围手术期治疗中合理应用的价值。方法 将64例胃癌患者随机分为营养支持组和非营养支持组 (各32例 ) ,营养支持组术前7d予肠外营养及术后早期予肠外 +肠内营养 ,非营养支持组仅予输注葡萄糖等。手术前后检查血常规、血特种蛋白、淋巴细胞 ,测24h尿氮含量。另选择常规体检正常者30名作正常对照组。结果 胃癌患者入院时前白蛋白和转铁蛋白水平较正常对照组明显降低 (P<0.01)。术前1d营养支持组经术前营养支持前白蛋白、转铁蛋白水平和淋巴细胞数显著升高 (P<0.05或0.01) ,与非营养支持组比较差别也有显著性意义 (P<0.05) ;术后第1、3天血浆蛋白虽有下降 ,但下降幅度平缓 (P>0.05) ;而非营养支持组与术前相比 ,上述指标明显下降 (P<0.05)。术后7d时 ,营养支持组的营养状况、免疫功能恢复至术前水平。术后并发症的发生率非营养支持组 (15.62% )高于营养支持组 (6.25% )。结论 对胃癌患者围手术期进行合理营养支持 ,可有效改善患者的营养、免疫状况 ,减少术后并发症 ,有利于术后康复

Evaluation of perioperative nutritional support in patients with gastric cancer

Objective To evaluate perioperative nutritional support in patients with gastric cancer.Me-thods Sixty four patients with gastric cancer were randomly divided into two groups:the nutritional support group(NS group) and without nutritional support group(WNS group)(n=32,respectively).The NS group was given parenteral nutritional support 1 week before operation and early given parenteral and enteral nutrition on postoperative day,the WNS group was only given intravenous glucose.Blood routine,serum albumin,total lymphocyte count and nitrogen content of 24h urine were monitored before and after operation.In addition,30 healthy subjects were selected as healthy control group.Results Prealbumin and transferrin were significantly lower in gastric cancer than those in healthy control group(P<0.01).Prealbumin,transferring and total lymphocyte count were increased significantly(P<0.05 or 0.01) by nutritional support in NS group on preoperative day and also significantly higher than those of WNS group(P<0.05).In NS group plasma albumin levels were decreased mildly,slowly(P>0.05) on the 1st,3rd day of postoperation.On the 7th day after operation there were no changes in nutritional status and immunofunction in NS group to those before operation.The incidence of postoperative complications in WNS group(15.62%) were higher than those in NS group(6.25%).Conclusions It is effective in improving nutritional status and immunofunction,reducing complications and enhancing recovery to give nutritional support reasonably to patients with gastric cancer.