肝癌肝叶切除患者术前口服碳水化合物联合术后早期进食效果观察

Effects of preoperative oral carbohydrate solution intake combined with early postoperative oral intake in patients undergoing hepatectomy for liver cancer

目的减轻原发性肝癌肝叶切除术患者手术炎性应激反应,促进康复。方法将174例原发性肝癌行肝叶切除术患者随机分为两组各87例。对照组行常规围术期饮食管理;观察组优化饮食管理方案,即术前口服碳水化合物,术后采取早期梯度递增法依次给予温开水、营养制剂、清流质、半流质、软食、普食进食方案。结果对照组82例、观察组86例完成研究进入数据分析。术后观察组C反应蛋白、IL-6值显著低于对照组(均P<0.05),首次经肛门排气时间、术后住院时间显著早于和少于对照组(P<0.05,P<0.01);两组均未发生误吸。结论术前口服碳水化合物联合术后早期进食方案可降低肝癌肝叶切除患者术后炎性应激反应水平,促进术后康复。

Objective To alleviate inflammatory stress response in patients with primary liver cancer undergoing hepatectomy and to promote their recovery.Methods Totally,174 patients undergoing hepatectomy for liver cancer were randomized into two groups,with 87 cases in each group.The control group received routine perioperative dietary management,while the intervention group was subjected to optimized dietary protocol:carbohydrate solutions were provided to drink before the surgery,and warm water,nutritional solutions,clear liquids,semi-liquid diet,soft food and common food were gradiently increased for oral intake after the surgery.Results Eighty-two patients in the control group and 86 in the intervention group completed the study.The intervention group had lower values of C-reactive protein and IL-6,earlier first passage of gas and shorter postoperative hospital stay compared with the control group(P<0.05,P<0.01).There was no aspiration in both groups.Conclusion Preoperative oral carbohydrate solution intake combined with early postoperative oral intake can reduce the level of postoperative inflammatory stress response and promote recovery.