早期肠内营养与肠外营养对肝癌肝切除患者肠道恢复及营养指标的影响

Effects of Early Enteral Nutrition and Parenteral Nutrition on Intestinal Rehabilitation and Nutrition Indicators of Liver Cancer Patients Treated with Hepatectomy

目的比较早期肠内营养与肠外营养对肝癌肝切除患者肠道恢复及营养指标的影响。方法回顾性分析86例肝癌肝切除患者的术后恢复信息。所有患者按照术后营养方式分为肠内营养组(EN)和肠外营养组(PN),各43例,且营养供给持续7天。临床研究信息包括术前术后2组患者的肝切除范围、营养状况、体重、上臂围、血清总蛋白、白蛋白以及前白蛋白,通过比较以上营养信息,评估EN和PN对肝切除患者肠道恢复的影响。结果营养治疗7天,2组患者的体重、上臂围,差异无统计学意义。2组术后24 h的血清总蛋白、白蛋白和前白蛋白低于术前水平,术后第7天EN组除白蛋白外,其余指标均恢复至术前水平,而PN组只有前白蛋白恢复正常,其余均低于术前水平。术后白蛋白输注量,PN组多于EN组(P=0.048)。结论早期EN治疗能够显著改善肝切除患者术后的营养和体质状况,术后并发症较少,优于肠外营养。

Objective To compare the effects of early enteral nutrition and parenteral nutrition on intestinal rehabilitation and nutrition indicators of liver cancer patients treated with hepatectomy.Methods Recovery information of 86 liver cancer patients treated with hepatectomy were retrospectively analyzed.All patients were divided into enteral nutrition group(EN) and parenteral nutrition group(PN) according to postoperative nutrition method,each with 43 cases,and the nutrients lasted for 7days.Clinical research information included liver resection area,nutritional status,body weight,arm circumference,serum total protein,albumin and prealbumin of the 2 groups before and after surgery,by comparing the above nutritional information,effects of EN and PN on intestinal recovery of liver cancer patients treated with hepatectomy were analyzed.Results 7 days after nutritional therapy,weight and arm circumference had no significant difference between the 2 groups.24-hour postoperative serum total protein,albumin and prealbumin levels decreased; 7 days after surgery,all the indicators except albumin in EN group recovered to preoperative level,and in PN group only albumin returned to normal,and the rest were lower than preoperative levels.Postoperative albumin dosage,PN group were higher than EN group(P = 0.048).Conclusion Early EN treatment can significantly improve nutrition and physical condition of liver cancer patients after liver resection,and has less postoperative complications than parenteral nutrition.