术前口服营养补充对食管癌患者术后并发症及营养状况的影响
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

基金项目:

江苏省“六大人才高峰”高层次人才C类资助项目(2016-WSW-015)


The effect of preoperative oral nutrition supplement(ONS) on the complication and nutritional status of patients with esophageal cancer
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:探讨术前口服营养补充对存在营养风险的食管癌患者术后并发症、住院时间、住院费用及围术期营养状况等指标的影响。方法:选择江苏省中医院行食管癌根治术,术前NRS2002(nutritional risk screening)评分≥3分的患者60例,随机分为对照组和实验组。对照组术前给予普通半流饮食。实验组术前除给予普通半流饮食外,另给予1周的口服营养补充(热量900 kcal/d,蛋白质32 g/d)。 记录患者术前一般基线资料及术后恢复指标,包括术后并发症发生率、术后引流量、术后通气时间、输入白蛋白及输血的情况、住院时间及花费;观察围术期血清学营养指标的变化情况,包括术前、术后(1、3、5、7 d)的血清白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白的水平。结果:实验组术后并发症的发生率显著低于对照组(16.7% vs. 40.0%, P<0.05),尤其是肺部并发症(6.7% vs. 30.0%,P<0.05)。实验组患者术后白蛋白的输入量显著少于对照组[(58.0±14.9)mL vs. (76.5±37.9)mL, P<0.05)],术后住院时间[(15.7±4.3)d vs. (18.8±5.1)d, P<0.05]及总住院时间[(22.7±5.7)d vs.(25.8±5.1)d, P<0.05]均显著短于对照组,住院费用也显著少于对照组[(66 290.8±9 922.3)元 vs. (72 491.8±12 535.1)元, P<0.05]。两组患者的血清学营养指标包括白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白均表现为术后较术前显著性下降(P<0.05),术后第3天达到最低点,此后出现缓慢上升,然而到了术后第7天仍显著低于术前水平(P<0.05)。实验组术后1、3、5、7 d的前白蛋白水平显著高于相应对照组(P<0.05),术后1、3、7 d的视黄醇结合蛋白水平亦显著高于对照组( P<0.05)。结论:给予有营养风险的食管癌患者实施术前1周的口服营养补充可以显著改善其围术期营养状态,降低术后并发症、住院时间及住院费用,是一种简单易行、有效的营养支持方式。

    Abstract:

    Objective: To investigate the effect of preoperative oral nutrition supplement (ONS) on the complication and perioperative nutritional status of the patients with esophageal cancer who had nutritional risk. Methods: A total of 60 patients with esophageal cancer with nutritional risk screening (NRS)2002≥3 who underwent surgery were randomly divided into the study and control groups. The study group received one week ONS (900 kcal/day of calories and 32 g/day of protein) before surgery and the control group received common semifluid diet only. The preoperative baseline data and postoperative indicators including postoperative complications, volume of drainage, time to exsufflation, albumin and blood transfusion, hospitalization duration and expense and the perioperative serum nutritional indicators (including levels of serum albumin, prealbumin, transferrin and retinol-binding protein before and 1, 3, 5, 7 d after surgery) were recorded. Results: Compared with the control group, the total complication rate (16.7% vs. 40.0%, P<0.05) and the pulmonary complication rate (6.7% vs. 30.0%, P<0.05) were significantly reduced in the study group. The perioperative albumin infusion [(58.0±14.9) mL vs. (76.5±37.9) mL,P<0.05], postoperative hospitalization durations [(15.7±4.3) d vs. (18.8±5.1) d, P<0.05] and total hospitalization time [(22.7±5.7) d vs. (25.8±5.1) d, P<0.05] and expense [¥(66 290.8±9 922.3) vs. ¥(72 491.8±12 535.1), P<0.05] were all significantly decreased in the study groups. The level of serum nutritional indicators including albumin, prealbumin, transferrin, retinol-binding protein fell significantly after operation, came to the deepest point on the 3th day after operation and gradually rose after that. However, they were still significantly lower than basal level on the 7th day. The prealbumin level of the study group on the 1th, 3th, 5th, and 7th day after operation were all significantly lower than those of the control group (P<0.05), which was the same as to the retinol-binding protein except on the 5th day (P<0.05). Conclusion: One week ONS before operation can effectively promote the nutritional status and postoperative rehabilitation of patients, reduce the incidence of postoperative complications, shorten hospital stay and decrease the expense.

    参考文献
    相似文献
    引证文献
引用本文

张 颖,叶生爱,朱 祺,于 裕,邹浩生,程 亮.术前口服营养补充对食管癌患者术后并发症及营养状况的影响[J].南京医科大学学报(自然科学版),2017,(10):1283-1287

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2017-06-26
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2017-11-06
  • 出版日期:
通知关闭
郑重声明