44例胃癌术前营养支持

Preoperative nutrition support in patients with advanced gastric cancer

44例2000-01～2002-02期间的胃癌病人,全部为根治性手术.其中有营养支持者28例(A组),无营养支持者16例(B组).PN给1075-1950kal/d,EN给国产复方要素饮食300-400g/d.测定A、B组手术前后体重、白蛋白、淋巴细胞计数:A组体重平均下降(5.0士0.65)kg,白蛋白下降(4.0士1.25)g/L,淋巴细胞计数下降(0.014士0.206)×109/L,B组体重下降平均(5.2士1.20)kg,白蛋白下降(4.5士0.72)g/L,淋巴细胞下降(0.555士0.246)×109/L.两组下降值比较,无显著差异(P＞0.05).A组平均年龄(62.8士2.3)岁,B组(54.9士4.3)岁,两组年龄无显著差异.但A组25/28例为全胃或近端根治性胃大部分切除,常规切除左半胰脏及脾脏,术后禁食9d,B组13/16为远端胃大部分切除,不需切除左半胰和脾,术后禁食3d,A组手术范围、创伤、禁食时间远超过B组.因此认为,A组的营养支持是有效的.

In this study, 44 cases of advanced gastric cancer reviewed all received radical gastrectomy. . Nutrition support was given in 28 cases (group A), either by PN or EN preoperatively. No nutrition support in 16 cases (group B) except ringer lactate and 5% glucose infusion as fluid therapy. Body weight, serum albumin and peripheral lymphocyte count were assessed preoperatively and 2 weeks postoperatively. Postoperatively the mean loss of body weight was (5. 0±0. 65)kg in group A and (5. 2±1. 20)kg in group B;serum albumin decrease was (4. 0±1. 25)g/L in group A and (4.5±0. 72)g/L in group B; lymphocyte count was (0. 014±0. 206)×109/ L in group A and (0. 555±0. 246)×109/L in group B, With no significant difference between the two groups ( P >0. 05). The average ages in group A were (62. 8±2. 3) years old and (54. 9±4. 3) years old in group B ( P >0. 05). It must be emphasized that in group extensive radical proximal gastrectomy with splenectomy and left half pancreatectomy was performed in 25 in 28 cases, while in group B radical subtotal gastrectomy and B reconstruction in 13 of 16 cases. Thus, it is suggested that preoperative nutrition support was effective in patients with advanced gastric cancer undergoing major respective surgery.