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腹腔镜胃癌根治术患者围手术期营养支持治疗情况

Analysis of perioperative nutrition support therapy in patients undergoing laparoscopic radical gastrectomy

  • 摘要:
    目的 分析腹腔镜胃癌根治术患者围手术期营养支持治疗情况。
    方法 回顾性分析2017年1月1日至2019年12月31日行限期腹腔镜胃癌根治术患者的临床资料,分析围手术期营养支持治疗情况。
    结果 共纳入410例患者,术前营养风险和营养不良发生率为分别为43.66%(179/410)和8.05%(33/410)。围手术期营养支持治疗以术后为主,为265例,而术前仅13例。术后营养支持治疗以肠外营养(PN)为主,应用率达到88.30%(234/265)。术后PN支持方式包括全合一(all in one,AIO)混合型营养液和单瓶氨基酸输注,分别占9.40%(22/234)和90.60%(212/234);其中,AIO供给能量为(20.02±3.15)kcal·kg-1·d-1、氮量为(0.14±0.04)g·kg-1·d-1、热氮比为(124.75±45.56):1;单瓶氨基酸能量为(8.63±2.29)kcal·kg-1·d-1、氮量为(0.24±0.14)g·kg-1·d-1、热氮比为(128.49±40.90):1。术后肠内营养(EN)的应用率为25.28%(67/265),以经口补充营养(ONS)为主。术前存在营养风险的患者中,接受营养支持治疗者较未接受者术后并发症发生率明显降低(P < 0.05)。
    结论 临床医生对营养支持治疗的认识较以往提高,但规范性还需进一步提升。

     

    Abstract:
    Objective To analyze the application of nutrition support therapy in patients undergoing laparoscopic radical gastrectomy.
    Methods The clinical data of patients undergoing limited-period laparoscopic radical gastrectomy from January 1, 2017 to December 31, 2019 were retrospectively collected and analyzed. The clinical application of nutrition support and treatment during the perioperative period was analyzed.
    Results A total of 410 patients were included. The incidence of preoperative nutritional risk and malnutrition were 43.66% (179/410) and 8.05% (33/410), respectively. The perioperative nutrition support and treatment was mainly used after surgery in 265 cases, and only 13 patients were given nutrition support before surgery. Nutrition support was mainly given through parenteral nutrition (PN), with an application rate of 88.30% (234/265). The application rates of postoperative PN support with all in one (AIO) mixed nutrient solution and simple amino acid infusion were 9.40% (22/234) and 90.60% (212/234), respectively. The energy supplied by AIO was (20.02±3.15) kcal·kg-1·d-1, the amount of nitrogen was (0.14±0.04) g·kg-1·d-1, the ratio of heat to nitrogen was (124.75±45.56)∶1. The energy supply in a single bottle of amino acid infusion was (8.63±2.29) kcal·kg-1·d-1, the amount of nitrogen was (0.24±0.14)g·kg-1·d-1, and the ratio of heat to nitrogen was (128.49±40.90)∶1. The application rate of postoperative enteral nutrition (EN) mainly through oral nutrition supplement (ONS) was 25.28% (67/265). Among patients with preoperative nutritional risk, those who received nutritional support treatment had a significantly lower postoperative complication rate than those who did not (P < 0.05).
    Conclusions The concept of nutrition support therapy has been improved, but the standardization needs to be further improved.

     

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