低氮低热量肠外营养与传统氮热量肠外营养对胃癌术后患者的影响

发布时间：2018-05-05 02:15

本文选题：低氮低热量 + 传统氮热量　；参考：《南昌大学》2015年硕士论文

【摘要】：目的:研究低氮低热量肠外营养对胃癌患者术后血糖、营养、免疫、炎症反应及术后恢复的影响,并探讨低氮低热量肠外营养支持方案对胃癌术后患者的临床应用。方法:将58例胃癌患者随机分为低氮低热量肠外营养组和传统氮热量肠外营养组,分别在术后第1天至第5天给予相应热量和氮量的肠外营养支持,并于术前、术后检测患者血糖、营养、免疫、C反应蛋白指标及观察患者术后恢复情况。结果:(1)低氮低热量PN组术后血糖控制明显优于传统氮热量PN组,术后第一天、术后第二天、术后第三天及术后第四天患者血糖水平差异有统计学意义(P0.05),而术前第一天及术后第五天两组患者血糖水平均无统计学意义(P0.05)。(2)两组患者术后均存在负氮平衡,两组患者术前、术后的营养指标如白蛋白、前白蛋白及视黄醇蛋白,其差异均无统计学意义(P0.05)。(3)术前一天及术后第六天两组患者免疫指标无统计学差异(P0.05)。(4)两组患者术前一天及术后第三天C反应蛋白差异无统计学意义(p0.05),而术后第六天两组患者的C反应蛋白差异有统计学意义(P0.05)。(5)低氮低热量PN组术后感染率低于传统氮热量PN组,两组感染例数差异无统计学意义。(6)两组患者术后肛门排气时间、切口拆线时间及术后住院时间差异无统计学意义(P0.05)。结论:低氮低热量肠外营养支持方案对胃癌患者术后短期应用具有可行性,同时能更好的稳定患者术后血糖水平,可能降低术后感染率,减轻机体急性炎性反应,并有可能促进患者术后康复。
[Abstract]:Objective: to study the effects of low nitrogen and low calorie parenteral nutrition on postoperative blood glucose, nutrition, immunity, inflammatory reaction and postoperative recovery in patients with gastric cancer, and to explore the clinical application of low nitrogen and low calorie parenteral nutrition in patients with gastric cancer after operation. Methods: Fifty-eight patients with gastric cancer were randomly divided into low nitrogen and low calorie parenteral nutrition group and traditional nitrogen caloric parenteral nutrition group. Blood glucose, nutrition, immuno-C reactive protein index and postoperative recovery were observed. Results (1) the control of blood glucose in low nitrogen and low calorie PN group was significantly better than that in traditional nitrogen calorie PN group, the first day and the second day after operation. On the third day and the fourth day after operation, there was a significant difference in blood glucose levels between the two groups (P 0.05), but there was no significant difference in blood glucose levels between the two groups on the first day of operation and on the fifth day after operation. Postoperative nutritional indicators such as albumin, prealbumin and retinol protein, There was no significant difference in immunological indexes between the two groups on the first day before operation and on the sixth day after operation. (P 0.05) there was no significant difference in C-reactive protein between the two groups on the first day before operation and on the third day after operation, but there was no significant difference in C-reactive protein between the two groups on the sixth day after operation. The infection rate of low nitrogen and low calorie PN group was lower than that of traditional nitrogen calorie PN group. There was no significant difference in the number of infection cases between the two groups. (6) there was no significant difference in postoperative anal exhaust time, incision removal time and postoperative hospitalization time between the two groups (P 0.05). Conclusion: low nitrogen and low calorie parenteral nutrition support regimen is feasible for patients with gastric cancer. It can stabilize blood glucose level, reduce postoperative infection rate and alleviate acute inflammatory reaction. It is possible to promote postoperative recovery of patients.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2;R459.3

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