解剖性肝切除术后营养支持治疗的疗效分析

The effect of postoperative nutritional support on anatomical hepatectomy

目的:研究分析肠外全营养混合液(TNA)对解剖性肝切除术后病人的疗效。方法:采用前瞻性对照研究方法将108例原发性肝癌病人分为静脉营养支持治疗组(TNA组)和对照组,两组病人在解剖性肝切除术后第8天检测营养相关指标,肝功能指标,术后并发症,住院时间和费用。结果:与对照组比较,TNA组术后清蛋白和前清蛋白均较对照组显著提高,血红蛋白和淋巴细胞计数与对照组比较无显著差异;TNA组术后第8天的ALT,AST和LDH水平与对照组比较均显著降低,两组的GGT,TB和DB水平无显著差异。TNA组术后感染相关并发症共计9例,对照组为16例,TNA组胸腔积液和腹水共计17例,对照组为32例。两组间住院费用无显著统计学差异(P>0.05),TNA组术后住院时间较对照组显著缩短(P<0.05)。结论:解剖性肝切除术后TNA支持能改善病人的营养状况和肝功能,减少术后并发症的发生率。

Objective： The effect of postoperative nutritional support on anatomical hepatectomy was investigated with a randomized,controlled clinical trial.Methods： One hundred and eight patients were randomly divided into two groups： TNA group（n=58） and Control group（n=50）.Patients in TNA group received TNA support for seven days after anatomical hepatectomy.Venous heparin blood samples were obtained for assay on day 8 after surgery.Results： A significant elevation of albumin and prealbumin was shown in TNA group（P〈0.05）.A significant decrease of ALT、AST and LDH was observed on day 8 in TNA group（P〈0.05）.There were 9 cases with infective complication in TNA group,and 16 cases in control group.Compared with control group,a significant decrease of postoperative hospital stay was observed in TNA group.Conclusion： Post-hepatectomy nutritional support can greatly improve metabolism of protein and nutrition states of patients.