CAJ | 학술논문

目的：对喉癌患者进行术前营养评价及术后肠内营养支持的效果观察。方法选择1996年1月-2012年12月解放军白求恩国际和平医院收治的喉癌择期手术患者611例,对术前营养状况进行评价,术后经鼻胃管给予高能高蛋白全营养粉剂,每日能量125.4~146.3 kJ(30~35 kcal)/kg理想体重,蛋白质1.2~1.5 g/kg理想体重。分别于术前、管喂第1天、管喂第7天和管喂停止日测量体重和血清白蛋白、前白蛋白、血红蛋白、淋巴细胞总数,观察消化道症状和切口愈合情况。结果16.0%的患者术前体重过低,10.8%存在低白蛋白血症。除体重外,管喂停止日患者血清白蛋白、前白蛋白、血红蛋白、淋巴细胞总数均较管喂第1天明显升高(P<0．05,P<0．01),达到术前水平。95.7%的患者手术切口一期愈合。仅4.3%的患者发生咽瘘,经积极处理瘘口均愈合。结论术后积极进行科学的肠内营养支持可改善喉癌患者的营养状况,促进切口愈合,降低并发症的发生率。
목적：대후암환자진행술전영양평개급술후장내영양지지적효과관찰。방법선택1996년1월-2012년12월해방군백구은국제화평의원수치적후암택기수술환자611례,대술전영양상황진행평개,술후경비위관급여고능고단백전영양분제,매일능량125.4~146.3 kJ(30~35 kcal)/kg이상체중,단백질1.2~1.5 g/kg이상체중。분별우술전、관위제1천、관위제7천화관위정지일측량체중화혈청백단백、전백단백、혈홍단백、림파세포총수,관찰소화도증상화절구유합정황。결과16.0%적환자술전체중과저,10.8%존재저백단백혈증。제체중외,관위정지일환자혈청백단백、전백단백、혈홍단백、림파세포총수균교관위제1천명현승고(P<0．05,P<0．01),체도술전수평。95.7%적환자수술절구일기유합。부4.3%적환자발생인루,경적겁처리루구균유합。결론술후적겁진행과학적장내영양지지가개선후암환자적영양상황,촉진절구유합,강저병발증적발생솔。
Objective To evaluate the preoperative nutritional status and observe the effect of postoperative en-teral nutritional support in patients with laryngeal cancer. Methods A total of 611 patients with laryngeal cancer during January 1996 and December 2012 in Bethune International Peace Hospital of PLA were enrolled in this study. Preopera-tive nutritional evaluation was performed, and patients received an enteral diet supplements of high energy and protein through nasogastric tubes after operation with energy 125. 4 -146. 3 kJ (30 -35 kcal)/(kg·d) and protein 1. 2 -1. 5 g/(kg·d). Body weight and levels of serum albumin, serum prealbumin, hemoglobin and total lymphocyte count (TLC) were detected before the operation, 1st and 7th d feeding and the day when feeding was suspended, and gastroin-testinal symptoms and wound healing were also observed. Results A total of 16. 0% patients had low body weight, and 10. 8% patients had hypoalbuminemia. Levels of serum albumin, serum prealbumin, hemoglobin and TLC were signifi-cantly higher on the day of when feeding was suspended except body weight than those on 1st d of feeding (P<0. 05,P<0. 01), which were equal to preoperative levels. A total of 95. 7% patients had primary healing, and 4. 3% patients had pharyngeal fistula and were healed after active treatment. Conclusion Scientific and reasonable enteral nutritional sup-port for laryngeal cancer patients after operations may improve nutritional status, promote wound healing and reduce inci-dence rate of complication.