低氮低热量肠外营养支持对胰腺癌患者术后恢复的影响

Effects of hypocaloric and lower nitrogen parenteral nutrition support on postoperative recovery of the patients with pancreatic cancer

目的观察低氮低热量肠外营养支持对胰腺癌患者术后早期恢复的影响。方法采用前瞻、随机、对照的方法，将符合入选标准的胰腺癌术后患者60例，随机分为对照组（n=30）和研究组（n=30），分别给予传统肠外营养（热量每日117．6kJ／kg体重，氮每日0．2g／kg体重）和低氮低热量营养（热量每日75．6kJ／kg体重，氮每日0．1g／kg体重），观察输营养液过程中血红蛋白、白细胞、肝肾功能、血糖水平、氮平衡的变化及感染相关并发症等。结果两组患者术后1、4、7d的血红蛋白、白细胞、肝肾功能、氮平衡等指标差异均无统计学意义（P〉0．05）；对照组的空腹血糖及输液后2h血糖水平均显著高于研究组（P〈0．05），静脉炎的发生率也明显高于研究组（P〈0.05）。结论胰腺癌术后早期给予低氮低热量PN支持，在不影响患者营养状态的情况下，很好的控制了血糖水平及其相关并发症，是一种安全有效的治疗方法。

Objective To evaluate the effect of bypocaloric and lower nitrogen parenteral nutrition support on early recovery after operation in the patients with pancreatic cancer. Methods In a prospective ,randomized and controlled trial, 60 patients with pancreatic cancer after surgical operation were randomly divided into control group （n = 30） and study group（ n = 30） ,subjected to traditional parenteral caloric （ 117.6 kJ/kg · d^ - 1 ） and nitrogen （0.2 g/kg· d ^- 1 ） nutrition, and to hypocalorie （75.6 kJ/kg·d^-1 ） and lower nitrogen （0.1 g/kg·d^-1 ） parenteral nutrition respectively. The hemoglobin, leukocytes, liver and renal functions, blood glucose level, nitrogen balance and infection related complications were observed during nutrition fluid transfusion after operation. Results There was no significant difference in hemoglobin, leukocytes,liver and renal functions and nitrogen balance between control group and study group （ P 〉 0.05 ）. The fasting blood glucose and glucose levels, and the incidence of phlebitis after transfusion were significantly higher in the control group than in the study group （ P 〈 0.05 ）. Conclusion The use of hypocaloric and lower nitrogen parenteral nutrition had controlled the blood glucose levels and the related complications well without influencing the nutritional status of the patients.