摘要
目的探究营养风险筛查及肠内外序贯营养支持对结直肠癌患者预后的影响。方法选取2018年1月—2019年1月于我院就诊的结直肠癌患者140例,经NRS 2002筛查,≥3分的患者120例。根据营养支持方案的不同,将120例患者分为肠内营养组、肠外营养组以及肠内外序贯营养组,每组40例。比较三组患者术后3周的人体成分、外周血指标、术后恢复情况、生活自理能力、并发症发生率,并分析影响患者预后的主要因素。结果营养支持治疗后,三组患者人体成分[细胞总液量、躯干水分、蛋白总量、身体脂肪比、基础代谢率、身体质量指数(BMI)]均显著升高,而外周血指标(血红蛋白、前白蛋白、白蛋白、红细胞、白细胞)均明显降低,肠内外序贯营养组人体成分、外周血指标均高于肠内营养组和肠外营养组,差异具有统计学意义(P<0.05);肠内外序贯营养组术后首次通气时间、下床时间、首次经口进食时间显著短于肠内营养组和肠外营养组(P<0.05);肠内外序贯营养组胃肠应激性溃疡、肺部感染、消化道出血、腹腔感染及切口愈合不良等并发症的发生率均明显低于肠内营养组与肠外营养组(P<0.05)。Logistic单因素分析与多因素回归分析结果显示,白蛋白、肠内外序贯营养支持、NRS评分及BMI是影响结直肠癌患者预后的主要因素(P<0.05)。结论经NRS 2002营养风险筛查,对存在营养风险的结直肠癌患者给予肠内外序贯营养支持,能够改善其预后和营养状况,值得临床推广使用。
Objective To investigate the effect of nutritional risk screening(NRS)and sequential nutritional support on prognosis of patients with colorectal cancer.Methods 140 patients with colorectal cancer who were treated in our hospital between January 2018 and January 2019 were selected.After screening with NRS 2002,there were 120 patients with scores≥3.According to the different nutritional support schemes,the patients were divided into enteral nutrition group,parenteral nutrition group and sequential enteral and parenteral nutrition group,40 cases in each group.The changes of body compositions,peripheral blood indexes,postoperative recovery,self-care ability,postoperative complications of the three groups were compared at 3 weeks after operation,and the main factors affecting the prognosis were analyzed.Results After nutritional support treatment,the body composition indexes[total cell fluid volume,total body water,total protein,body fat ratio,basal metabolic rate,body mass index(BMI)]of patients were significantly increased in three groups.The indexes of peripheral blood indexes(hemoglobin,prealbumin,albumin,red blood cell and white blood cell)of patients were significantly decreased in three groups.The body composition and peripheral blood indexes of the sequential enteral and parenteral nutrition group were higher than those of the enteral or parenteral nutrition group(P<0.05).The time to first ventilation,time of off-bed and time to first oral feeding in parenteral and enteral sequential nutrition groups were significantly shorter than those in enteral or parenteral nutrition groups(P<0.05).The incidence rate of postoperative complications such as gastrointestinal stress ulcer,pulmonary infection,gastrointestinal bleeding,abdominal infection and poor wound healing in the sequential enteral and parenteral nutrition group was significantly lower than that in the enteral nutrition group and parenteral nutrition group(P<0.05).Logistic univariate and multivariate regression analysis showed that albumin,sequential en
作者
宋海涛
戴咏梅
徐艳
SONG Haitao;DAI Yongmei;XU Yan(Qingdao Municipal Hospital,Qingdao,Shandong,266071,China)
出处
《肿瘤药学》
CAS
2021年第3期366-371,共6页
Anti-Tumor Pharmacy
关键词
结直肠癌
营养风险筛查
肠内外序贯营养支持
预后
Colorectal cancer
Nutritional risk Screening
sequential enteral and parenteral nutrition support
Prognosis
