胰头癌围手术期营养支持

Perioperative Nutrition Support of the Patients with Pancreatic Head Cancer

目的评估围手术期肠内外营养支持对胰头癌患者术后营养状况及并发症的影响。方法以2000年1月～2004年4月在我院接受治疗,并在围手术期应用肠内外营养的胰头癌患者34例(治疗组)及同期行手术治疗后给予单独肠外静脉营养的胰头癌患者48例(对照组)为研究对象,根据手术方式不同,将实验组及对照组再分为胰十二指肠切除术(Whipple术)组(治疗组n=13,对照组n=24)及姑息手术组(治疗组n=21,对照组n=24),对各组术前术后体重变化、总蛋白和白蛋白改善情况,及术后并发症发生率等指标进行比较。结果治疗组手术前后总蛋白和白蛋白改善情况明显优于对照组(P均<0.05);治疗组中Whipple术组患者的术后并发症发生率、手术前后体重变化及总蛋白改善情况均明显优于对照组中Whipple术组患者(P均<0.05)。结论围手术期应用肠内外营养可明显改善胰头癌患者的营养状况,降低术后并发症发生率,值得临床推广。

Objective To explore the effect of perioperative nutrition support on nutritional condition and complications of the patients with postoperative pancreatic head cancer. Methods Thirty four patients received perioperative nutrition support, including enteral nutrition and parenteral nutrition （treatment group）. Forty eight patients received routine postoperative parenteral nutrition（control group）. According to the operative method, these two groups were further divided into two sub-groups： （1） pancreaticoduodenectomy （PD） subgroup, including 13 cases from treatment group, and 24 cases from control group; （2） palliative operation subgroup, including 21 cases from treatment group, and 24 cases from control group. Body weight, total protein （TP）, serum albumin （ALB）, and the complications after operation were compared. Results The concentrations of ALB and TP in the treatment group were significantly higher than those in the control group （P〈0.05）. Body weight and TP of the patients received PD in the treatment group were significantly better than those of the control group （P 〈 0.05）. Conclusion Perioperative nutrition support can improve postoperative nutritional condition and reduce the postoperative complications in patients with pancreatic head cancer.