上消化道手术后肠内、肠外营养支持前后血浆抗氧化维生素的变化

Antioxidant vitamin status in patients receiving enteral or parenteral nutrition after upper gastrointestinal surgery

目的了解胃肠手术患者术后接受肠内营养(EN)和肠外营养(PN)时血清抗氧化维生素的变化情况,以指导临床营养补充。方法对笔者2所医院接受上消化道肿瘤手术的120名患者随机平均分组为EN组和PN组,检测两组手术前、EN或PN前后的维生素A(VA)和维生素E(VE)及β-胡萝卜素的水平。结果患者术后血浆VA和β-胡萝卜素显著下降(P=0.03,P=0.01);营养辅助治疗10周后,两组VE水平显著下降,且EN组VE水平低于PN组(P<0.01),而VA和VE在营养辅助前后水平无显著变化(P>0.05)。结论手术应激可引起外周血VA和β-胡萝卜素水平下降,VE则在术后发生持续下降,EN或PN均无法避免,需予以积极补充。

Objectlve To study the plasma antioxidant vitamin status in patients receiving enteral nutrition （ EN ） or parenteral nutrition （ PN ） after upper gastrointestinal surgery. Methods One hundred and twenty patients who underwent upper gastrointestinal cancer surgery were randomized into EN and PN group. The plasma vitamin A, vitamin E and β-carotene levels pre-and post-operation and one week after clinical nutrition supplement were studied. Results Vitamin A and β-carotene levels decreased significantly after surgery （ P = 0.03 and P = 0.01 , respectively ）. Vitamin E decreased 10 weeks after the nutrition, and it was significantly lower in the EN group than in the PN group （ P 〈 0. 01 ） , whereas vitamin A and β-carotene changed only slightly after nutrition （ P 〉 0. 05 ）. Conclusions A decrease of antioxidant vitamins is induced by surgery and vitamin E is recommended to be given in nutrition supplement patients, especially in the patients receiving EN.