中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2009年
2期
141-144
,共4页
丁国平%陈平%易占波%郑祺
丁國平%陳平%易佔波%鄭祺
정국평%진평%역점파%정기
胃肿瘤%营养风险筛查%肠内营养,预防性
胃腫瘤%營養風險篩查%腸內營養,預防性
위종류%영양풍험사사%장내영양,예방성
Stomach neoplasms%Nutrition risk screening%Enteral nutrition,preventive
目的 研究营养风险筛查(NRS 2002)评价胃癌患者术前营养状况的可行性与临床适用性,探讨对伴有营养风险的患者行预防性肠内营养支持的临床意义.方法 对60例胃癌患者进行NRS 2002评分.将NRS阳性组患者随机分为对照组和试验组,试验组术前3 d在正常饮食基础上每天口服能全力1000 ml(4184 kJ/L),对照组继续日常饮食.术后观察各组感染并发症发生情况和血清白蛋白、免疫球蛋白及体质量等指标的变化.结果 胃癌患者NRS阳性率70%(42/60),NRS阴性组(无营养不良风险)18例.NRS阴性患者术后白蛋白水平明显高于NRS阳性对照组(P<0.01);血清IgA、IgM水平亦高于NRS阳性对照组(P<0.05);体质量也优于NRS阳性对照组(P<0.01).NRS阳性试验组术后血清白蛋白和IgA水平均较同期对照组高(P<0.05和P<0.01),体质量下降幅度较对照组少(P<0.01);感染并发症两组比较差异无统计学意义(P>0.05).结论 NRS 2002评分方法适用于胃癌患者术前营养不良风险的评估.对伴有营养风险的胃癌患者进行术前肠内营养支持能有效改善其术后的营养状态和提高其胃肠道免疫功能.
目的 研究營養風險篩查(NRS 2002)評價胃癌患者術前營養狀況的可行性與臨床適用性,探討對伴有營養風險的患者行預防性腸內營養支持的臨床意義.方法 對60例胃癌患者進行NRS 2002評分.將NRS暘性組患者隨機分為對照組和試驗組,試驗組術前3 d在正常飲食基礎上每天口服能全力1000 ml(4184 kJ/L),對照組繼續日常飲食.術後觀察各組感染併髮癥髮生情況和血清白蛋白、免疫毬蛋白及體質量等指標的變化.結果 胃癌患者NRS暘性率70%(42/60),NRS陰性組(無營養不良風險)18例.NRS陰性患者術後白蛋白水平明顯高于NRS暘性對照組(P<0.01);血清IgA、IgM水平亦高于NRS暘性對照組(P<0.05);體質量也優于NRS暘性對照組(P<0.01).NRS暘性試驗組術後血清白蛋白和IgA水平均較同期對照組高(P<0.05和P<0.01),體質量下降幅度較對照組少(P<0.01);感染併髮癥兩組比較差異無統計學意義(P>0.05).結論 NRS 2002評分方法適用于胃癌患者術前營養不良風險的評估.對伴有營養風險的胃癌患者進行術前腸內營養支持能有效改善其術後的營養狀態和提高其胃腸道免疫功能.
목적 연구영양풍험사사(NRS 2002)평개위암환자술전영양상황적가행성여림상괄용성,탐토대반유영양풍험적환자행예방성장내영양지지적림상의의.방법 대60례위암환자진행NRS 2002평분.장NRS양성조환자수궤분위대조조화시험조,시험조술전3 d재정상음식기출상매천구복능전력1000 ml(4184 kJ/L),대조조계속일상음식.술후관찰각조감염병발증발생정황화혈청백단백、면역구단백급체질량등지표적변화.결과 위암환자NRS양성솔70%(42/60),NRS음성조(무영양불량풍험)18례.NRS음성환자술후백단백수평명현고우NRS양성대조조(P<0.01);혈청IgA、IgM수평역고우NRS양성대조조(P<0.05);체질량야우우NRS양성대조조(P<0.01).NRS양성시험조술후혈청백단백화IgA수평균교동기대조조고(P<0.05화P<0.01),체질량하강폭도교대조조소(P<0.01);감염병발증량조비교차이무통계학의의(P>0.05).결론 NRS 2002평분방법괄용우위암환자술전영양불량풍험적평고.대반유영양풍험적위암환자진행술전장내영양지지능유효개선기술후적영양상태화제고기위장도면역공능.
Objective To investigate the potential role of the preventive nutritional support in patients with nutritional risk defined by nutrition risk screening 2002 (NRS 2002) before radical resection of gastric cancer. Methods Patients with gastric cancer were evaluated by NRS 2002 preoperatively. Elective patients with nutritional risk were randomly assigned into 3 d preventive enteral nutrition(EN) group versus control group. The preventive nutrition regimen was 1000 ml Nutrison Multi Fibre (4184 kJ/L). The changes in body weight lost, serum albumin, immunoglobulin were recorded postoperatively. Results One week after operation, the preventive EN group showed less decrease in body weight as compared to control group, which was statistically significant. The levels of serum albumin and IgA on day 1 and day 3 after operation in preventive EN group were significantly higher than those in control group. Conclusion Before operation for gastric cancer, patients with nutritional risk defined by NRS 2002 may benefit from preventive enteral nutrition, which improves the patients' nutritional condition and enhances their immunologic function.
