术前强化口服辅助营养在老年胃肠道肿瘤外科中的应用研究

摘要

Abstact: ObjectiveTo investigate the influence of preoperative enriched supplementary enteral nutrition on elderly patients with gastrointestinal cancer.Method Patients with nutritional risk were selected from preliminary diagnosed elderly gastrointestinal cancer. These patients were randomly divided into the control group given traditional nutritional support method and the test group given enriched supplementary enteral nutrition. The levels of albumin (ALB), pre-albumin (PA), transferring (TF) and lymphocyte count (LY) were observed and compared between the two groups on admission, preoperative day 1, postoperative day 3.Postoperative complications and the hospitalization cost, length of stay was recorded.Result The PA, TF were significant different in Different groups of nutritional preparations after 1 days before and 3 days after operation (P<0.05), the detection level of the test group was higher than control group (P<0.05). The LY, ALB levels in 3 days postoperatively were significant higher than control group (P<0.05). There was a significant difference of anal exsufflation time and out of bed activity time in test group and control group (P<0.05). The incidence rate of postoperative total infection and total complications postoperative were significant difference between the two groups (P<0.05). The average hospitalization time in test group was (16.5±6.8)days, the control group was (23.0±6.6) days, there were significant differences between them (P<0.05).Conclusion Preoperative enriched supplementary enteral nutrition is safe and effective, which is an appropriate choice to improve the nutrition and decrease infectious complication and promote rehabilitation of the patients with gastrointestinal cancer during the perioperative period.%目的探索术前强化口服辅助营养在老年胃肠道手术治疗中的作用。方法选择2010年1月至2015年12月间有营养不良风险的老年胃肠道肿瘤外科患者，采用前瞻性随机对照研究，对伴有营养不良风险的老年胃肠道肿瘤患者进行随机分组，在术前进行营养干预，试验组给予术前强化口服辅助营养，对照组给予常规术前准备，比较两组患者在术前和术后白蛋白（albumin， ALB）、前白蛋白（prealbumin，PA）、转铁蛋白（treansferrin，TF）及外周血淋巴细胞计数（lymphocyte count，LY）等营养指标以及术后并发症及住院时间等情况，并对比住院费用等差异。结果不同营养准备后的患者在术前1天及术后第3天PA、TF在两组间差异均具有显著性（P＜0.05），试验组检测水平高于对照组，术后3天的LY、ALB水平试验组高于对照组（P＜0.05）。两组患者术后肠道排气时间、术后下床时间比较差异具有显著性（P＜0.05）。在术后总感染并发症及总并发症发生率试验组低于对照组，两组间差异有显著性（P＜0.05）。试验组平均住院时间（16.5±6.8）天，对照组为（23.0±6.6）天，两者之间差异有显著性（P＜0.05）。结论术前强化口服辅助营养对于改善老年胃肠道肿瘤患者的术后营养状况、降低术后并发症及促进术后康复方面效果明显，可作为有营养风险老年胃肠道肿瘤患者的营养支持手段。