CAJ | 학술논문

目的评价术前肠内营养支持应用于伴营养风险胃癌患者的临床疗效和安全性.方法前瞻性入组2012年5-10月间四川大学华西医院收治的60例伴营养风险的胃癌患者,按随机数字表法分为试验组(30例)和对照组(30例).试验组以安素作为肠内营养制剂,术前连续服用10 d,对照组进食等热量等氮的匀浆膳.检测患者入院时、术前1d和术后3d营养相关指标及肝肾功能指标,并记录恶心、呕吐等围手术期不良反应的发生情况.结果两组患者入院时基线水平一致(均P＞0.05).术后3d,试验组较对照组患者血清白蛋白[(33.9±5.6) g/L比(31.0±5.3) g/L,P＜0.05]和血红蛋白水平[(103.4±7.7) g/L比(96.6±10.5) g/L,P＜0.01]均明显升高;而体质量指数、淋巴细胞计数、血糖浓度、血钾、血钠及肝、肾功能指标两组差异均无统计学意义(均P＞0.05).两组各有2例患者出现恶心症状,各有1例出现呕吐症状,试验组患者未出现肠内营养相关的严重不良临床事件.结论术前肠内营养支持应用于伴营养风险胃癌患者疗效显著,安全性高,是临床纠正营养风险的合理选择.
목적 평개술전장내영양지지응용우반영양풍험위암환자적림상료효화안전성.방법 전첨성입조2012년5-10월간사천대학화서의원수치적60례반영양풍험적위암환자,안수궤수자표법분위시험조(30례)화대조조(30례).시험조이안소작위장내영양제제,술전련속복용10 d,대조조진식등열량등담적균장선.검측환자입원시、술전1d화술후3d영양상관지표급간신공능지표,병기록악심、구토등위수술기불량반응적발생정황.결과 량조환자입원시기선수평일치(균P＞0.05).술후3d,시험조교대조조환자혈청백단백[(33.9±5.6) g/L비(31.0±5.3) g/L,P＜0.05]화혈홍단백수평[(103.4±7.7) g/L비(96.6±10.5) g/L,P＜0.01]균명현승고;이체질량지수、림파세포계수、혈당농도、혈갑、혈납급간、신공능지표량조차이균무통계학의의(균P＞0.05).량조각유2례환자출현악심증상,각유1례출현구토증상,시험조환자미출현장내영양상관적엄중불량림상사건.결론 술전장내영양지지응용우반영양풍험위암환자료효현저,안전성고,시림상규정영양풍험적합리선택.
Objective To evaluate safety and efficacy of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition.Methods A single center randomized controlled clinical trial was performed in 60 gastric cancer patients in West China Hospital from May to October 2012.Thirty patients were given enteral nutrition support (Ensure(R))manufactured by Abbott Laboratories for ten consecutive days before surgical operation in the treatment group,and 30 patients were given an isocaloric and isonitrogenous homogenized diet in the control group for 10 days as well.The laboratory parameters of nutritional status and hepatorenal function were observed and compared between the two groups on admission,preoperative day 1 and postoperative day 3,respectively.Clinical observations,such as nausea and vomiting,were carried out until patients were discharged.Results Before the intervention,there were no significant differences in the baseline characteristics between the two groups.The levels of serum albumin [(33.9±5.6) g/L vs.(31.0±5.3) g/L,P＜0.05],and hemoglobin [(103.4 ±7.7) g/L vs.(96.6 ±10.5) g/L,P＜0.01] were significantly improved in the treatment group on postoperative day 3.However,the levels of body mass index,lymphocyte count,liver and renal function,serum glucose,sodium,and potassium were not significantly different between the two groups (all P＞0.05).Moreover,two patients with nausea and one with vomiting in each group were found.In clinical observation period,no severe treatment-related adverse event were observed.Conclusion The enteral supplement with Ensure(R) in gastric cancer patients at risk of malnutrition during preoperative period is effective and safe,which is superior to homogenized diet and an appropriate choice for gastric cancer patients with nutritional risk.