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目的探讨不同肠外营养(parenteral nutrition,PN)支持方案对消化道恶性肿瘤术后患者相关指标的干预作用。方法胃肠道术后患者66例随机分为常规输液组(A组)、低热量PN组(B组)、传统热量PN组(C组),每组22例,监测营养干预前、干预后第3、7天的生化指标情况。结果 3组患者不同检测时间的血清总蛋白(total protein,TP)、白蛋白(albumin,ALB)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)、γ—谷胺酰转肽酶(γ—glutamyl transpeptidase,γ-GT)、碱性磷酸酶(alka—line phosphatase,ALP)、血红蛋白(hemoglobin,HGB)和淋巴细胞百分率(1ymphocyte percentage,LYMPH)组内比较差异有统计学意义(P<0.05);分组因素对血清ALB、AST、ALT、ALP和LYMPH值的影响差异有统计学意义(P<0.05);时间与分组的交互因素对3组患者血清TP、ALB、AST、ALT、TBIL、ALP和LYMPH值均有影响,差异有统计学意义(P<0.05)。干预7天,B组血ALB值、LYMPH值均高于A、C组,血清AST、ALT和ALP值均低于A、C组(P<0.05);3组患者血TP、HGB值比较差异无统计学意义(P>0.05)。结论低热量PN支持方案对消化道恶性肿瘤患者术后营养、免疫和肝功能指标的干预效果优于常规输液组和传统热量PN组。
Objective To investigate the intervention effects of different parenteral nutrition (PN) regimens on related indicators of postoperative patients with gastrointestinal cancer. Methods Sixty-six patients with gastrointestinal tract were randomly divided into routine infusion group (group A), low-calorie PN group (group B) and traditional calorie PN group (group C) with 22 patients in each group. Before and after nutrition intervention, 3,7 days of biochemical indicators of the situation. Results The serum levels of total protein (TP), albumin (ALB), aspartate aminotransferase (AST), alanine aminotransferase ALT, total bilirubin (TBIL), γ-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), hemoglobin HGB and 1ymphocyte percentage (LYMPH), there was a significant difference between the two groups (P <0.05). The effects of grouping factors on serum ALB, AST, ALT, ALP and LYMPH were statistically significant (P < 0.05). The interaction of time and group had significant effect on serum TP, ALB, AST, ALT, TBIL, ALP and LYMPH in the three groups (P <0.05). The serum ALB and LYMPH values in group B were higher than those in group A and C at 7 days of intervention, and the levels of AST, ALT and ALP in serum were lower than those in groups A and C (P <0.05) No statistical significance (P> 0.05). Conclusions The intervention effect of low-calorie PN support on postoperative nutrition, immune and liver function indexes of patients with gastrointestinal cancer is better than that of conventional infusion group and traditional caloric PN group.