胃肠道肿瘤患者围手术期不同营养支持方法的研究

Research on Different Nutritional Support Methods During Perioperative Surgery in Patients With Gastrointestinal Cancer

目的对胃肠道肿瘤患者围手术期的营养支持方案及效果进行分析和评价。方法对2015年2月—2016年2月接受根治术治疗的93例胃肠道肿瘤患者的临床资料进行回顾性分析,根据围术期营养支持方式的不同分成探究组(50例)和常规组(43例),常规组实施肠外营养支持(TPN),探究组实施肠内营养支持(EN),均连续进行7 d,对比分析两组手术前后的血清蛋白、TNF-α及机体免疫指标水平,同时对比两组术后肛门排气恢复时间及并发症发生情况。结果术后,两组患者的血清蛋白、机体免疫等相关指标均有降低,但探究组降低幅度小于常规组(P<0.05),且TNF-α水平高于常规组(P<0.05);探究组术后肛门排气时间短于常规组,差异有统计学意义(P<0.05);两组术后均未出现严重并发症。结论在胃肠道肿瘤患者围术期实施EN支持,有助于改善患者机体营养和免疫功能,促进肠胃功能恢复,且术后并发症少。

Objective To analyze and evaluate the effect of perioperative nutritional support program for patients with gastrointestinal cancer. Methods The clinical data of 93 patients with gastrointestinal cancer undertaken radical operation from February 2015 to February 2016 was retrospectively analyzed, and the patients were divided into the study group （50 cases） and the conventional group （43 cases） based on different perioperative nutritional support methods. The conventional group administered parenteral nutrition support, the study group administered enteral nutrition support, both with 7 consecutive days. The levels of serum protein, TNF-a and immune index between two groups were analyzed before and after operation, the anal exhaust recovery time and complications occurrence in two groups also investigated. Results The serum protein, immune and other related parameters after surgery in both groups were decreased, with less decrease in study group than the conventional group （P 〈 0.05）, higher TNF-α than the conventional group （P 〈 0.05） and hadstatistically significant difference between study group and conventional group with shorter anal exhaust recovery time than the latter （P 〈 0.05）, without severe complication in both group. Conclusion Implementing EN support to patients with gastrointestinal cancer during the perioperative period can help to improve the nutrition and immune function, promote gastrointestinal function recovery with less postoperative complications, the clinical value also being significant.