摘要
目的探讨低热量肠外营养在老年胃癌患者术后的应用。方法59例老年胃癌患者术后随机分为29例低热量肠外营养组（低热量组）和30例常规肠外营养组（常规组），术后第2天起低热量组给予84kJ·kg^-1·d^-1的肠外营养支持，常规组给予126kJ·kg^-1·d^-1的肠外营养支持，共6d。观察两组患者营养支持期间的并发症、血清蛋白、免疫功能、炎症反应、血糖、肝功能及胃肠道功能恢复时间。结果低热量组和常规组患者术后并发症发生率分别为37．9％（11／29）和43．3％（13／30），以肺部感染为主（P〉0．05）；术后3d及6d血清白蛋白、总蛋白及前白蛋白水平常规组与低热量组比较差异无统计学意义（P〉0．05）；术后两组外周血淋巴细胞总数及T淋巴细胞亚群CD3＋、CD4＋、CD4＋／CD8＋比值均降低，CD8＋值升高，两组差异无统计学意义（P〉0．05）；两组C反应蛋白术后3d比术前明显升高，术后6d比术后3d降低（P〉0．05）；两组血糖术后3d、6d逐渐降低（P〉0．05）；术后肝功能指标均升高，术后3d时两组比较差异无统计学意义（P〉0．05），术后6d时常规组仍持续升高，两组比较差异有统计学意义（P〈0．05）；低热量组患者术后排气、排便时间与常规组比较，差异无统计学意义（P〉0．05）。结论老年胃癌患者术后低热量肠外营养支持是一种安全有效的营养支持方法。
Objective To investigate the postoperative elderly patients with gastric cancer. application of hypocaloric parenteral nutrition in Methods 59 elderly patients aged 60-79 years with gastric cancer after operation were randomly assigned to receive 84 kJ . kg -1. d -1hypocaloric parenteral nutrition （29 cases） and 126 kJ . kg-1 . d-1 standard-calorie parenteral nutrition （30 cases）, totally 6 d from postoperative 2 d. Complications, serum proteins, immune function, inflammation, blood glucose, liver function and recovery time of gastrointestinal function were observed during nutritional support. Results The postoperative complication rate were 37.9%（11/ 29） in hypocalorie group and 43.3%（13/30） in standard calorie group （P〉0.05）, mainly pulmonary infection. There were no differences in levels of serum albumin, total protein and prealbumin between two groups at postoperative 3 d and 6 d （P〉0. 05）. Peripheral blood lymphocytes and T lymphocyte subsets CD3＋ , CD4＋ , CD4＋/CD8＋ ratio were decreased after sugery, but CD8＋ values increased in two groups （P〉0. 05）. C reactive protein was increased significantly at postoperative 3 d compared with preoperation, and decreased at 6 d than 3 d （P〉0. 05）. Blood glucose was decreased gradualiy at 3 and 6 d （P〉0. 05）. Postoperative liver function parameters were elevated, no difference was found at 3 d （P〉0.05）, and continued to rise at 6 d in standard calorie group than in hypocalorie group （P〈0.05）. There was no difference in times of aerofluxus and cacation after operation between hypocalorie and standard calorie groups （P〉0.05）. is a safe and effective method for nutrition support cancer. Conclusions Hypocaloric parenteral nutrition in postoperative elderly patients with gastric
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第3期225-228,共4页
Chinese Journal of Geriatrics
基金
浙江省医药卫生科技计划资助（2006A113）
关键词
胃肿瘤
胃肠外营养
热量限制
Stomach neoplasms
Parenteral nutrition
Caloric restriction
