胃肠道恶性肿瘤患者围手术期两种营养支持方式的临床研究

Clinical research on providing nutritional support to patients with gastrointestinal neoplasm malignant in two different ways during their perioperative period

目的比较胃肠道恶性肿瘤患者围手术期采用两种方式进行营养支持的临床效果。方法将41例胃肠道癌症患者分为TPN组(19例)和对照组(22例)。TPN组以中心静脉置管给予全肠外营养(total parenteral nutrition,TPN)对患者进行围手术期营养支持;对照组采用周围静脉单瓶输入各种营养液。比较两组手术前后血清白蛋白(ALB)、血红蛋白(HGB)、肝功能指标、并发症及不良反应。结果两组患者术后1天血清白蛋白较术前均明显下降(对照组P<0.01,TPN组P<0.05),7天后血清白蛋白较术后1天均有所回升,但和术前比较TPN组P>0.05,对照组P<0.01;TPN组手术前后血红蛋白变化不大(P>0.05),对照组血红蛋白术后则有明显下降(P<0.05);TPN组术后肝功能指标升高较对照组更明显(P<0.05),发生肠外营养相关肝功能损伤(PNALD)4例,对照组发生其他并发症或不良反应3例。结论TPN支持更有利于维持患者血清白蛋白和血红蛋白的稳定,同时可以避免周围静脉输入途径容易产生的各种并发症和不良反应,但是相比之下TPN更容易导致肝功能损伤。

Objective To understand the clinical effects of the nutritional support given to patients with gastrointestinal neoplasm malignant in two different ways during their perioperative period.Methods 41 patients with gastrointestinal neoplasm malignant were divided into two groups,the TPN group(19 patients) and the control group(22 patients).The TPN group had been given total parenteral nutrition(TPN) through central veins while the control group had been given various kinds of nutrition fluids consecutively thr...