营养支持对胃肠道肿瘤患者术后营养状况及恢复的影响

Effects of nutritional support on nutritional status and recovery of patients with gastrointestinal neoplasms after operation

目的探讨营养支持在胃肠道肿瘤患者术后营养状况及恢复中的作用。方法35例胃肠道肿瘤且伴有营养不良的患者,行根治性手术后随机分为3组,对照组为术后常规补液5～7d,完全胃肠外营养支持(TPN)组术后采用TPN治疗3～5d,EN组术后早期给予肠内营养支持5～7d。并检测术后营养状况指标及患者恢复情况。结果对照组术后血清总蛋白、白蛋白、前白蛋白、转铁蛋白水平较术前显著下降(P<0.05),TPN组、EN组各项指标较术前降低,但差异无显著性。TPN组、EN组患者术后并发症及住院天数均少于对照组。结论术后肠内、外营养支持能够改善胃肠道肿瘤患者营养状况,减少术后并发症的发生、缩短住院天数。术后早期施行TPN抑或EN是安全、可行和有效的。

Objective To evaluate the effects of nutritional support in patients with gastrointestinal neoplasms on nutritional status after surgical procedure. Methods 35 patients with malnutrition were involved in this study. The patients were randomly divided into three groups. The control group received only routine intravenous infusion without any nutritional support for 5 to 7 days postoperatively. The TPN (total parenteral nutrition) group received TPN support after operation for 3 to 5 days. The EN (enteral nutrition) group received early postoperative feeding for 5 to 7 days. Results Compared with the preoperative values, the postoperative serum level of total protein, albumin, proalbumin and transferrin in the control group decreased significantly (P<0.05), while the level of those data from TPN and EN groups also decreased but there were no insignificant differences. The occurrence of postoperative complication in the TPN group and the EN group were fewer than those in the control group. Conclusions The present study suggests that early post-operative TPN and EN support can improve the patients' nutritional status and reduce the incidence of postoperative complication. Nutritional support at early stage after operation is safe, feasible and effective.