结肠癌老年患者术前肠外营养支持对术后营养状况及胃肠功能恢复的影响

The clinical effect of early PN on the improvement of recovery of gastrointestinal function and nutritional status in elderly patients with preoperative surgerye colon cancer

[目的]探讨术前肠外营养应用在老年结肠癌手术患者中的应用效果及临床价值。[方法]将90例在我院行手术切除的老年结肠癌患者采用随机数字表法分为观察组与对照组,对照组在术后开展肠外营养支持,观察组联合术前肠外营养支持,记录患者术后的营养状况及胃肠道功能恢复情况。[结果]观察组术后肛门排气时间(41.13±4.87)h,肛门排便时间(53.67±5.11)h,住院时间(18.77±3.42)d;对照组术后肛门排气时间(68.75±7.23)h,肛门排便时间(73.84±8.03)h,住院时间(24.56±5.53)d,2组对比差异有统计学意义(P<0.05)。观察组治疗后血红蛋白(143.28±8.83)g/L,总蛋白(62.79±6.15)g/L,白蛋白(37.86±2.96)g/L;对照组治疗后血红蛋白(128.53±6.17)g/L,总蛋白(55.66±4.24)g/L,白蛋白(33.95±2.03)g/L,2组对比差异有统计学意义(P<0.05)。观察组术后发生肠梗阻1例,腹腔感染1例,泌尿系感染2例;对照组术后发生肠梗阻7例,切口感染4例,腹腔感染6例,泌尿系感染8例,2组对比差异有统计学意义(P<0.05)。[结论]采用术前肠外营养应用在老年结肠癌手术患者中可以改善患者术后营养状况,有效缩短患者胃肠功能恢复时间和住院时间,降低术后并发症发生,值得在临床上推广应用。

[Objective]Discusse the application of preoperative parenteral nutrition in the elderly patients with colon cancer surgery application effect and clinical value.[Methods]Ninety patients in our hospital surgical removal of the old patients with colon cancer using the random number table method were divided into observation group and control group,control group in postoperative parenteral nutrition support,observation in combination with preoperative parenteral nutrition support,and nutritional status of the patients with postoperative recovery of gastrointestinal function.[Result]Observation group of postoperative anal exhaust time（41.13±4.87）h,anal defecation time（53.67±5.11）h,length of hospital stay（18.77±3.42）d;Control group（68.75±7.23）for postoperative anal exhaust time h,anal defecation time（73.84±8.03）h,length of hospital stay（24.56±5.53）d,statistical analysis showed that contrast differences between groups with statistical significance（P〈0.05）.Observation group after treatment of hemoglobin（143.28 ＋8.83g/L,total protein（62.79±6.15）g/L,albumin（37.86±2.96）g/L;The control group after treatment of hemoglobin（128.53±6.17）g/L,total protein（55.66±4.24）g/L,albumin（33.95±2.03）g/L;Statistical analysis showed that contrast differences between groups with statistical significance（P〈0.05）.Observation group of postoperative intestinal obstruction in 1case,abdominal infection in 1case,urinary tract infection in 2cases;Control postoperative intestinal obstruction in 7cases,infection of incision,4cases,6ca-ses of abdominal cavity infection,urinary tract infection in 8cases,statistical analysis showed that contrast differences between groups with statistical significance（P〈0.05）.[Conclusion]Preoperative parenteral nutrition in the elderly patients with colon cancer surgery patients can improve postoperative nutritional status,effectively shorten the patients with gastrointestinal function recovery time and hospital stay,and reduce the postoperative complications.It was worthy of popularization and application in clinic.