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《原發(fā)性肝癌手術(shù)前后營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查及臨床分析-論文.pdf》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、臨床外科雜志2013年12月第21卷第l2期JClinSurg，December2013，Vo1．21，No．12·933··論著·原發(fā)性肝癌手術(shù)前后營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查及臨床分析王代宏王芳元王偉劉志蘇[摘要]目的探討原發(fā)性肝癌患者手術(shù)前后營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查及聯(lián)合腸內(nèi)、腸外營(yíng)養(yǎng)模式對(duì)臨床結(jié)局的影響。方法參照NRS2002工具標(biāo)準(zhǔn)，36例患者住院后第1天進(jìn)行營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查，評(píng)分t>3分給予營(yíng)養(yǎng)支持，術(shù)前術(shù)后進(jìn)行腸外腸內(nèi)營(yíng)養(yǎng)支持(研究組)。30例患者術(shù)前不進(jìn)行任何營(yíng)養(yǎng)評(píng)價(jià)，術(shù)后全部接受腸外腸內(nèi)營(yíng)養(yǎng)支持(對(duì)照組)，比較兩組患者術(shù)后肝功能、凝血功能、白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞比率及C反應(yīng)蛋白指標(biāo)的變化，同
2、時(shí)記錄患者術(shù)后SIRS發(fā)生情況、感染性并發(fā)癥的發(fā)生率及術(shù)后住院時(shí)間、住院費(fèi)用。結(jié)果研究組患者術(shù)后第7天血清谷丙轉(zhuǎn)氨酶(AST)及C反應(yīng)蛋白明顯低于對(duì)照組(P<0．05)，其余指標(biāo)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P>0．05)。研究組患者術(shù)后SIRS發(fā)生率、術(shù)后感染性并發(fā)癥發(fā)生率及術(shù)后住院時(shí)間、住院費(fèi)用明顯低于對(duì)照組(P<0．05)。結(jié)論對(duì)于肝癌手術(shù)患者，入院時(shí)應(yīng)進(jìn)行營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查，有營(yíng)養(yǎng)風(fēng)險(xiǎn)者，術(shù)前、術(shù)后聯(lián)合營(yíng)養(yǎng)支持有益于改善術(shù)后營(yíng)養(yǎng)狀況和縮短住院時(shí)間，減少醫(yī)療費(fèi)用，改善臨床結(jié)局。[關(guān)鍵詞]肝癌；營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查；營(yíng)養(yǎng)支持；臨床結(jié)局[中圖分類(lèi)號(hào)]R735．7[文獻(xiàn)標(biāo)識(shí)碼]A[DOI]10．396
3、9／j．issn．1005-6483．2013．12．017Pre-andpost-operativenutritionalriskscreeningandclinicalanalysisinpatientswithhepatocellu-larcarcinoma^Dai—hong，』、，G一yuan，，vG，eta1．(DepartmentofGeneralSurgery，XianningCentralHospital，Hubei437100，China)[Abstract]0bjectiveToexploretheeffectsofpre-andpost—operative
4、nutritionalriskscreening(NRS)andnutritionsupportoncliniealoutcomesinpatientswithhepatocellularcarcinoma．MethodsAccordingtotheNRS2002standard．theNRSscoringwasperformedatthefirstdayofhospitalization．Nu—tritionalriskWaSdefinedasNRS2002scores≥3．Patientswithnutritionalriskreceivedenteralnutrition
5、(EN)andparenteralnutrition(PN)supportpreoperativelyandpostoperatively．ThecontrolgroupreceivedENandPNsupportafteroperationwithoutNRS．Liverfunction．bloodcoagulationfunction．whitebloodcellcounts．percentageofneutrophilsandlevelsofserumC．reactiveprotein(CRP)weredetectedandcomparedbetweenthegroups
6、．Theincidenceofsystemicinflammatoryresponsesyndrome(SIRS)，infectiouscompli。cation．hospitalstayandtotalmedicalcostweremeasuredafteroperation．ResultsOnthe7thdayafteroperation，theserumlevelsofaspartatetrransaminase(AST)andCRPinthestudygroupweresignificantlylowerthanthoseinthecontrolgroup(P<0．05
7、)．Thoseotherindictionswerenotsignificantlydifferentbe．tweentwogroups(P>0．05)．TheincidenceofSIRSandinfectiouscomplication．hospitalstayandtotalmedicalcostinthestudygroupwassignificantlylowerthanthatinthecontrolgroup(P<0．05)．Conclu-sionForpatientswith
