腹部肿瘤术后采取混合糖溶液营养支持的临床观察

Clinical Observation of Nutrition Support with Mixed Carbohydrates Solution in Patients with Abdominal Tumor Undergoing Surgical Resection

目的探讨腹部肿瘤患者术后静脉应用混合糖溶液对其营养代谢指标的影响。方法选取腹部肿瘤且行根治术的成年患者56例,随机分为混合糖营养支持组和单糖营养支持组两组,术后3d禁食并分别持续静脉输注10.5%的混合糖溶液或10%的葡萄糖单糖溶液1000ml/d,测末梢血血糖并据此调整胰岛素用量,记录血糖、胰岛素情况且每天检测C反应蛋白(C-reactive protein,CRP)的水平。结果术后72h内,两组患者术后的血糖水平都较术前有所增高,在术后使用胰岛素情况下两组之间的血糖水平差异无统计学意义(P>0.05);混合糖组胰岛素用量显著低于单糖组(P<0.01);两组患者的CRP水平都较术前有所升高,单糖组较混合糖组升高更加明显(P<0.05)。结论腹部肿瘤根治术的患者,术后禁食并应用混合糖溶液作为糖源供能,机体血糖波动较小。此外,在减轻术后应激性炎症反应方面也起到了一定的作用。

Objective To investigate the effects of intravenous nutrition with mixed carbohydrate solution in patients subject to abdominal cancer and radical operation. Methods Fifty-six patients with abdominal cancer undergoing radical operation were randomly divided into two groups according to their postoperative intravenous nutrition support of carbohydrates, i.e., Mixed Carbohydrate Group （n=28） in which specially mixed fructose and glucose and xylitol solution was given and Glucose Solution Group （n=28） in which only 10% G.S. was administered, both 1 000 ml daily. Insulin was administrated according to the blood glucose levels. Results Postoperative blood glucose and Creaction protein （CRP） levels of all patients were more or less increased during the first 72 hours. Although their insulin-adjusted blood glucose levels demonstrated no great differences （P〉0.05）, insulin prescription was significant higher in pure glucose group （P〈0.01）, accompanied by significantly elevated CRP levels （P〈0.05）. Conclusion Postoperative supplementation of solution composed of mixed carbohydrates in proper ratio may result in favorable effects in patients with abdominal cancer undergoing radical resection by lowering postoperative glucose stress and inflammatory responses when compared with pure glucose infusion.