不同蛋白质入量对老年胃癌术后患者的影响

Effects of different protein intake on elderly patients with gastric cancer after surgery

目的探讨不同蛋白质入量肠内营养对老年胃癌围手术期患者的影响。方法选择2021年1月至2022年9月在普外肿瘤科进行胃癌手术的年龄≥60岁的老年患者100例, 随机分为两组, 每组50例。对照组给予标准蛋白肠内营养制剂瑞素, 观察组添加乳清蛋白, 按0.3 g/(kg·d)添加, 对比患者蛋白、血脂、血糖、术后首次肛门排气排便和住院时间、免疫及炎症指标、术后6个月的生存情况、术后6个月的再住院率。计数资料采用χ^(2)检验, 计量资料采用t检验。结果 14 d营养补充后, 与对照组比较, 观察组血清白蛋白(ALB)、前白蛋白(PAB)、总蛋白(TP)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)和血糖(BS)大幅度升高(t=8.890、2.762、6.328、1.998、4.602、9.806、2.491、3.427, P<0.05), 同时各指标观察组明显高于对照组(P<0.05);术后肛门排气、排便时间、住院天数观察组明显优于对照组(t=3.835、3.980、2.194, P<0.05);两种炎性因子水平显著下降(t=4.950、25.330, P<0.05);术后6个月的生存情况、术后6个月的再住院率比较结果显示观察组优于对照组, 差异有统计学意义(χ^(2)=2.210、2.874, P<0.05)。结论采用围手术期增加患者蛋白入量可以显著改善老年胃癌围手术期患者的蛋白质代谢, 提高生存质量。

Objective To explore the effect of different protein intake of isocaloric card on elderly patients with gastric cancer during perioperative period.Methods A total of 100 elderly patients aged 60 years or older who underwent gastric cancer surgery in the Department of General Surgery and Oncology from January 2021 to September 2022 were randomly divided into two groups,with 50 patients in each group.The control group was given the standard protein enteral nutrition preparation Ruisu,and the obser-vation group was added with whey protein at a dosage of O.3 g/(kg•d).The protein,blood lipid,blood sugar,the first anal exhaust and defecation after surgery and the length of hospital stay,immune and in-flammatory indicators,the survival of 6 months after surgery,and the readmission rate at 6th month after surgery were compared.The results were analyzed by SPSS 18 O statistical software.The data were ex-pressed as mean±standard deviation(x±s).The counting data were expressed as[example(%)]and an-alyzed by χ^(2) tests.The measurement data were analyzed by t-test.P<0.05 represents a statistically signifi-cant difference.Results After 14 days of nutrition supplement,compared with the control group,the lev-els of serum albumin,prealbumin,total protein,total cholesterol,low-density lipoprotein,high-density lipoprotein,triglyceride and blood sugar in the observation group increased(t=8.890,2.762,6.328.1.998,4.602,9.806,2.491,3.427,P<0.05).The first anal defecation was earlier and hospitalization days were shorter after operation(t=3.835,3.980,2.194,P<0.05).The levels of two inflammatory factors decreased significantly(t=4.950,25.330,P<0.05).The comparison of survival and readmis-sion rate at 6th month after surgery showed that the observation group was superior to the control group,with statistically significant differences(χ^(2)=2.210,2.874,P<0.05).Conclusion Increasing the pro-tein intake of patients perioperatively can significantly improve the protein metabolism and improve the quality of life of elderly patients with gastric cancer during perioperative period.