摘要
目的:分析胃癌根治术后患者营养风险筛查及其行早期肠内营养支持和肠外营养支持的效果对比。方法:随机选取我院97例胃癌根治术后患者,并按照NRS2002评估所有患者的营养情况,剔除<3分患者13例均未行营养支持治疗(NN组),84例存在营养风险患者分成肠外营养组(PN组)及肠内营养组(EN组)各42例。比较三组患者的临床疗效、营养状态、胃肠功能、免疫功能及术后并发症。结果:胃癌根治术后86.60%(84/97)患者存在营养风险。比较三组患者的手术时间、术中出血量及引流量均无显著差异(P>0.05)。EN组患者的住院天数、医疗费用、胃肠功能恢复状况显著优于PN组(P<0.05);治疗后7dEN组和PN组的血清白蛋白及前白蛋白表达水平显著高于治疗前(P<0.05)。治疗后7dEN组的CD_3^+、CD_4^+、CD_4^+/CD_8^+显著高于治疗前及PN组(P<0.05)。治疗后7dEN组的CD_8^+显著低于治疗前及PN组(P<0.05)。结论:NRS2002评分对指导胃癌根治术后患者的治疗具有一定价值。早期EN有利于减少手术时间、术中出血量,改善胃癌根治术后患者的营养状态及免疫功能。
Objective:To analyze the nutritional risk screening after radical gastrectomy and compare the effect of early enteral nutrition support and parenteral nutrition support.Methods:97 cases of gastric cancer were randomly selected in our hospital,and the nutritional status of all the patients was evaluated according to NRS2002.13 patients with<3 score were excluded from the nutritional support treatment(group NN),and 84 cases of nutritional risk patients were divided into parenteral nutrition group(group PN)and enteral nutrition group(group EN)in 42 cases.The clinical efficacy,nutritional status,gastrointestinal function,immune function and postoperative complications of the three groups were compared.Results:Nutritional risk was found in 86.60%(84/97)patients after radical gastrectomy.There was no significant difference in operative time,intraoperative blood loss and drainage volume among the three groups(P>0.05).The patients in group EN were significantly better than group PN(P<0.05),and the levels of serum albumin and prealbumin in the 7 days in the group EN and group PN were significantly increased in comparison of those before treatment(P<0.05).After treatment,CD 3+,CD 4+and CD 4+/CD 8+in 7 days in the group EN were significantly increased in comparison of those before treatment and group PN(P<0.05).After treatment,CD 8+in 7 days in the group EN was significantly decreased in comparison of before treatment and group PN(P<0.05).Conclusion:NRS2002 score is valuable in guiding the treatment of patients after radical gastrectomy.Early EN is beneficial to reduce operative time,intraoperative blood loss and improve the nutritional status and immune function of patients after radical gastrectomy.
出处
《陕西医学杂志》
CAS
2018年第10期1272-1274,1293,共4页
Shaanxi Medical Journal
