胃癌围手术期营养支持

Perioperative nutrition support in patients with advanced gastric cancer

对连续24例根治性胃癌手术病人回顾分析,有营养支持14例(A组),无营养支持10例(B组)。PN给1075～1950kcal/d,EN给国产复方要素饮食300～400g/d。测定A、B组手术前后体重、白蛋白、淋巴细胞计数:A组体重平均下降5.0±0.65kg,白蛋白下降4.0±1.25g/L,淋巴细胞计数下降0.014±0.206×10~9/L,B组体重平均下降5.2±1.20kg,白蛋白下降4.5±0.72g/L,淋巴细胞计数下降0.555±0.246×10~9/L,两组下降值比较,无显著差异(P】0.05)。A组平均年龄62.82±2.3岁,B组54.9±4.3岁,两组年龄无显著性差异,但A组12/14例为全胃或近端根治性胃大部切除,常规切除左半胰脏及脾脏,术后禁食9天,B组9/10例为远端胃大部切除,不需切除左半胰和脾,术后禁食3天,A组手术范围、创伤、禁食时间远超过B组。因此认为A组的营养支持是有效的。

In this study, 24 cases of advanced gastric cancer were reviewed all of then received radical gastrectomy. Nutrition support were given in 14 cases of then (group A) either by PN or EN perioperatively ; no nutrition support in other 10 cases (group B) except ringer lactate and 5% glucose sol infusion as fluid therapy.Body weight, serum albumin and peripheral lymphocytes count were assessed preoperatively and 2 weeks postoperatively. Postoperatively the mean decrement of body weight were 5. 0±0. 65kg in group A and 5. 2±1. 20kg in group B, of serum albumin were 4. 0±l. 25g/L in group A and 4. 5± 0. 72g/L in group B; of lymphocyte count were 0. 014-0. 206 × 109/L in group A and 0. 555±0. 246 × 109/L in group B. There were no signifcant differences between the two groups( P >0. 05).The average age in group A was 62. 8±2. 3 years old and 54. 9±4. 3 years old in group B( P > 0.05).It must be emphasized that in group A extensive radical total of proximal gastrectomy with splenectomy and left half pancreatectony were perforned in 12 cases, while in group B radical subtotal gastrectomy and B I reconstruction in cases. Thus, it suggests that perioperative nutrition support was effective in patients with advanced gastric cancer undergoing major resective surgery.