肠外营养对老年胃癌病人术后的作用

Application of parenteral nutrition in the elderly postoperative patients with gastric carcinoma

目的 :观察肠外营养 (PN)对老年胃癌病人术后的营养支持作用。 方法 :选择 2 0例术后应用PN治疗的老年胃癌病人作为PN组 ,并与同期未行PN治疗的 2 0例老年胃癌病人作对照。 结果 :①PN组术后并发症发生率为 15 % (3/ 2 0 ) ,无死亡 ;对照组为 4 5 % (9/ 2 0 ) ,病死率为 5 % (1/ 2 0 )。②PN组与对照组比 ,体重、肌酐 身高指数、血清白蛋白、转铁蛋白、血清尿素氮、氮平衡等均有显著差异 (P <0 .0 1)。③PN组血糖、三酰甘油、SGPT、AKP、γ GT等与对照组比均有显著升高。 结论 :PN可改善老年胃癌病人术后氮平衡和营养状况 ,降低蛋白质分解 ,减少术后并发症 ,但应掌握能量供给要适当的原则。

Objectives:To observe the role of parenteral nutrition(PN) in the elderly postoperative patients with gastric carcinoma. Methods:Forty cases were randomly divided into two groups. One group received PN after operation as PN group and another group was supported only with the general treatment without PN as control group. Results:①The rate of postoperative complications was 15% (3/20) with no death in PN group, and it was 45%(9/20) with mortality rate of 5%(1/20) in control group. ② Between the two groups, there were very significant differences in nitrogen balance, body weight, creatinine height index(CHI), serum albumin, serum transferrin and blood urea nitrogen(BUN) at the 8th postoperative day( P <0.01).③The levels of blood glucose, triglyceride, SGPT, AKP and γ GT were obviously elevated in PN group. Conclusions:PN can improve the nutritional status and nitrogen balance, decrease the decomposition of albumin and lower the complication rate in the elderly postoperative pateints with gastric carcinoma. It also suggests that PN support in the elderly patients should comply with the principle of proper calorie.