术前营养支持对于减少存在营养不良的胃癌患者术后呼吸系统并发症的作用

Effects of preoperative nutrition support on the postoperative respiratory complications in patients with gastric cancer complicated with malnutrition

目的:探讨术前营养支持对于减少存在营养不良的胃癌患者术后呼吸系统并发症的作用。方法:回顾分析2007年7月至2012年6月期间,符合研究标准的胃癌患者50例。所有患者均术后使用低氮低热量PN,研究组(25例)另术前给予营养支持7d。比较两组患者术后营养指标的变化、胃肠道功能恢复时间、呼吸系统并发症发生率、全身炎症反应综合症、营养支持相关费用及术后住院时间。结果:与对照组比较,研究组术后第7天营养指标恢复更好(P<0.05),术后肛门排气时间提早(P=0.033),呼吸系统并发症发生率低(P=0.012),全身炎症反应综合征发生率低(P=0.012),术后住院时间短(P=0.038)和营养支持费用少(P=0.030)。两组患者肠蠕动恢复时间以及营养支持总天数无明显差异(P>0.05)。结论:术前营养支持有利于减少存在营养不良的胃癌患者术后呼吸系统并发症的发生,有助于术后营养状况的改善和胃肠道功能的恢复,能够更好地节约医疗成本。

Objective To explore the effects of preoperative nutrition support on reducing postoperative respiratory complications in patients with gastric cancer complicated with malnutrition. Methods From July 2007 to June 2012, 50 patients with gastric cancer, in line with the research standard were enrolled. All patients receive hypocaloric and hyponitrogenic PN postoperatively, and patients in study group （n = 25） received additional preoperative nutrition support for 7 days. The nutrition index, recovery time of gastrointestinal function, incidences of respiratory implications and systemic inflammatory response syndrome, nutrition support costs and postoperative hospitalization time were analyzed. Results Compared with those in control group, the postoperative nutrition index in study group were better （P 〈 0.05）, the postoperative anal exhaust time was earlier （P = 0.033）, the incidences of respiratory complications and systemic inflammation response syndrome were less （P = 0.012, P = 0.012）, the postoperative hospitalization time was shorter （P = 0.038） and the nutrition support costs were less （P = 0.030）. The peristalsis recovery time and the total time of nutrition support were not significantly different between the two groups （P 〉 0.05）. Conclusion Preoperative nutrition support was helpful to reduce the postoperative respiratory complications in patients with gastric cancer complicated with malnutrition, was helpful to the postoperative nutrition improvement and the recovery of gastrointestinal function, and was helpful to save medical costs.