胃癌患者胃大部分切除术后感染与营养状态的相关性研究

Correlation between nutritional status and postoperative infection in gastric cancer patients undergoing subtotal gastrectomy

目的探究营养状态对胃癌大部分切除患者术后发生感染的影响。方法选取2016年4月-2017年4月医院收治的400例胃癌行胃大部分切除患者作为研究对象,采用随机数字表法将其分为研究组和对照组,每组200例。对照组患者采用常规治疗,研究组在对照组基础上采用早期肠内营养支持。观察两组患者术后营养相关指标(总蛋白、白蛋白、前白蛋白和铁蛋白)及并发症发生情况。结果治疗后研究组患者血清总蛋白、白蛋白、前白蛋白和铁蛋白指标水平均高于对照组(P均<0.05);研究组患者医院感染率为2.5%(5/200)低于对照组的7.0%(14/200),差异有统计学意义(χ^2=4.921,P=0.032);研究组患者发生胃瘫1例,对照组患者吻合口瘘、腹腔出血、肠梗阻和胃瘫均有发生;研究组患者住院时间(18.41+4.56)d相比对照组(22.58+5.48)d缩短,比较差异有统计学意义(t=3.674,P=0.026)。结论胃癌大部分切除患者营养指标与患者术后感染发生具有较强相关性,通过进行肠内营养积极补充干预能够有效地降低术后感染风险。

OBJECTIVE To explore the influence of nutritional status on postoperative infection in the patients undergoing the subtotal gastrectomy.METHODS A total of 400 gastric cancer patients who underwent the subtotal gastrectomy in the hospital from Apr 2016 to Apr 2017 were recruited as the study objects and randomly divided into the study group and the control group,with 200 cases in each group.The control group was treated with conventional therapy,while the study group was given the early enteral nutrition supportive therapy on basis of the treatment of the control group.The levels of the nutrition-related indexes such as total protein,albumin,prealbumin and ferritin as well as the incidence of complicated were observed and compared between the two groups of patients after the surgery.RESULTS The levels of serum total protein,albumin,prealbumin and ferritin of the study group were significantly higher than those of the control group after the treatment(all P<0.05).The incidence rate of nosocomial infection of the study group was 2.5%(5/200),significantly lower than 7.0%(14/200)of the control group(χ^2=4.921,P=0.032).There was 1 case of gastroplegia in the study group;anastomotic fistula,intra-abdominal hemorrhage,intestinal obstruction and gastroplegia occurred in the patients of the control group.The length of hospital stay of the study group was(18.41+4.56)days,significantly shorter than(22.58+5.48)days of the control group(t=3.674,P=0.026).CONCLUSIONThe nutrition indexes are highly associated with the postoperative infection in the gastric cancer patients undergoing the subtotal gastrectomy,and the enteral nutrition supportive therapy may effectively reduce the risk of postoperative infection.