CAJ | 학술논문

目的：探讨早期进食对促进肝癌患者术后快速康复的影响。方法随机将60例肝癌肝切除术后患者分成两组：早期进食组30例（A组），常规进食组30例（B组），比较两组患者术后肝功能、胃肠道功能恢复情况、感染率、并发症发生率、营养费用、睡眠质量及住院时间。结果早期进食组患者肠鸣音恢复时间（25.51±4.64）h、肛门排气时间（36.22±5.71）h以及首次排便时间（51.32±7.93）h与常规进食组（41.63±6.16）h，（58.44±7.94）h，（72.83±9.91）h相比有统计学差异（P<0.05）；术后第1天肝功能指标差异无显著意义（P>0.05）；术后第5天早期进食组谷丙转氨酶（63.22±18.76）U/L、总胆红素（20.12±5.76）μmol/L和直接胆红素（12.46±5.28）μmol/L水平较低，白蛋白（36.43±4.55）g/L水平较高，与对照组[（78.31±20.56）U/L，（25.33±6.26）μmol/L，（16.51±7.35）μmol/L，（31.91±3.66）g/L]相比差异均有统计学意义（P<0.05）；两组术后平均睡眠时间（7.9±1.6）h 对（6.0±1.2）h、胃肠道不适（10%对50%）、感染率（6.67%对26.67%）、术后营养费用（1000±433.5）元对（2200±493.4）元、住院时间（7.21±2.21）d 对（8.98±3.14）d比较差异有统计学意义（P<0.05）。结论肝癌肝切除术后早期饮食营养护理计划是更好的围手术期护理方案，安全可行，值得临床上进一步扩大验证。
목적：탐토조기진식대촉진간암환자술후쾌속강복적영향。방법수궤장60례간암간절제술후환자분성량조：조기진식조30례（A조），상규진식조30례（B조），비교량조환자술후간공능、위장도공능회복정황、감염솔、병발증발생솔、영양비용、수면질량급주원시간。결과조기진식조환자장명음회복시간（25.51±4.64）h、항문배기시간（36.22±5.71）h이급수차배편시간（51.32±7.93）h여상규진식조（41.63±6.16）h，（58.44±7.94）h，（72.83±9.91）h상비유통계학차이（P<0.05）；술후제1천간공능지표차이무현저의의（P>0.05）；술후제5천조기진식조곡병전안매（63.22±18.76）U/L、총담홍소（20.12±5.76）μmol/L화직접담홍소（12.46±5.28）μmol/L수평교저，백단백（36.43±4.55）g/L수평교고，여대조조[（78.31±20.56）U/L，（25.33±6.26）μmol/L，（16.51±7.35）μmol/L，（31.91±3.66）g/L]상비차이균유통계학의의（P<0.05）；량조술후평균수면시간（7.9±1.6）h 대（6.0±1.2）h、위장도불괄（10%대50%）、감염솔（6.67%대26.67%）、술후영양비용（1000±433.5）원대（2200±493.4）원、주원시간（7.21±2.21）d 대（8.98±3.14）d비교차이유통계학의의（P<0.05）。결론간암간절제술후조기음식영양호리계화시경호적위수술기호리방안，안전가행，치득림상상진일보확대험증。
Objective To explore the effect of early stage feeding on the patients with liver cancer after operation. Method Sixty liver cancer patients were randomly divided into early stage feeding group (Group A, n=30)and conventional feeding group(Group B,n=30). The liver function after operation,bowel movement recovery duration,postoperative infectious rate,postoperative morbidity,cost of nutritional support,sleep time per day and du-ration in hospital were compared between the two groups. Results Gastrointestinal tract discomfort rate(10%),in-fection rate(6.67%),nutrition cost(1000±433.5)yuan,bowel movement recovery duration(51.32±7.93)hand duration in hospital (7.21±2.21)d in the patients of group A were significantly lower than those in group B (50%,26.67%, (2200±493.4)yuan,(72.83±9.91)h,(8.98±3.14)d,(P<0.05),sleep time per day (7.9±1.6)h in patients of group A were significantly longer than that in group B (6.0±1.2)h,(P<0.05),and recovery of liver function for patients of group A were significantly better than those in group B[ALT(63.22±18.76)U/L vs.(78.31±20.56)U/l,TBIL (20.12±5.76)μmol/L vs.(25.33±6.26)μmol/L,CB(12.46±5.28)μmol/L vs.(16.51±7.35)μmol/L,ALB(36.43±4.55)g/L vs. (031.91±3.66g/L)]. Conclusion Early nutrition care plan is better for patients with liver cancer after hepatecto-my in perioperative period,which is safe and feasible and worthy of further clinical application.