结构脂肪乳与非结构脂肪乳对围手术期病人术后营养支持效果的比较:一项全国问卷调研

Comparison of the effect of structured fat milk and non-structured fat milk on postoperative nutritional support in perioperative patients: a national questionnaire survey

目的 研究真实世界结构脂肪乳(structured triglyceride, STG)与非结构脂肪乳(Non-structured triglyceride, NSTG)对围手术期病人营养支持效果的差异。方法 通过线上问卷方式,在全国范围内开展调研。调研问卷由问卷信息、病人信息、处方调研及术后观察4个模块,使用SPSS 24.0软件对STG组与NSTG组进行差异分析。结果 肠外营养前后,两组白蛋白(ALB)水平均升高(P<0.01),C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)水平均下降(P<0.01),STG组的血清甘油三酯(TG)水平差异无统计学意义,NSTG组则有所下降(P<0.05)。经重复测量资料广义线性方程分析,与NSTG组相比,STG组病人的ALB水平升高作用更明显(P<0.001),CRP、ALT下降更为明显(P均<0.001),但对TG的影响更小。结论 对于具有肠外营养需求的围手术期病人来说,STG带来的临床获益明显,应综合病人器官功能状态及经济情况,酌情使用STG。

Objective To investigate the difference between structured triglyceride(STG)and Non-structured triglyceride(NSTG)in nutritional support for perioperative patients.Methods A nationwide survey was conducted through online questionnaire.The questionnaire consisted of four modules:questionnaire information,patient information,prescription investigation and postoperative observation.SPSS 24.0 software was used for statistical analysis.Results Before and after parenteral nutrition(PN),the average levels of albumin(ALB)increased in both groups(P<0.01),while the levels of C-reactive protein(CRP)and alanine aminotransferase(ALT)decreased(P<0.01).The difference in serum triglyceride(TG)levels in the STG group was not statistically significant,while there was a decrease in the NSTG group(P<0.05).Generalized linear equation analysis of repeated measurements showed that compared to the NSTG group,the increase in ALB levels in the STG group patients was more significant(P<0.001),CRP and ALT decreases were more pronounced(P<0.001),but the impact on TG was smaller.Conclusions For perioperative patients with parenteral nutrition,STG supplementation can bring significant clinical benefits.STG should be used according to the organ function and economic situation of patients.