术前营养支持对结肠癌患者术后营养状况、并发症发生率影响的临床观察

The Influence of Preoperative Nutritional Support on the Postoperative Nutritional Status and the Complication Incidence of Patients with Colon Cancer

目的:探讨结肠癌者术前采用含有膳食纤维的能全力对术后早期肠内营养支持,改善患者营养状况及降低并发症发生率的影响。方法:选择结肠癌行根治性手术的病人为研究对象,随机分为两组各30例。予术前采用能全力进行营养支持(125.52kJ.k-1.d-1含氮量0.2g/kg)为实验组,采用普通饮食为对照组。分别测定其入院时、术前1d及术后1周营养相关指标。观察营养支持前后营养状况的改变及并发症,平均住院日及住院费用情况。结果:营养指标如臂围术后1周,血清白蛋白术前1d和术后1周均有明显改善,P值<0.05,其它营养指标如体重、血红蛋白均有不同程度改善,但P值>0.05,差异不显著。结论:有规律地早期补充肠内营养制剂可改善患者术后营养状况,并发症发生率、平均住院日和住院费用均可降低,提示术前营养支持和术后早期肠内营养是较优越、较经济的方案。

Objective：To study the influence of Nutrison Fibra taken by the patients with colon cancer before operation on the early postoperative enteral nutritional support, the improvement of nutritional status and reduction of complication incidence. Methods： 60 cases of patients with colon cancer which would undergo radical operation were randomly divided into two groups., experimental group which was supported with Nutrison Fibre before operation（ 12. 52kJ · kg^-1·d^-1） and control group which was put on full diet. The nutritional parameters in the two groups were determined on admission, on preoperative day 1 and postoperative day 7. The nutritional status change before and after nutritional support, the complications, the hospitalization days and the cost were recorded. Results： The arm measurement on postoperative day 7, the serum proteins on preoperative day 1 and postoperative day 7 were markedly improved （P〈0. 05）. Other nutritlonal parameters such as the body weight, the level of hemoglobin were improved in varying degree （P〉0. 05）, but the difference was unremarkable. Conclusion： Regular and early addition of enteral nutritional preparation can improve the nutritional status of postoperative patients, and the complications, average hospitalizaion days and the cost can be reduced. It is indicated that the preoperative nutritional support and early postoperative enteral nutritional addition are a better and more economical program.