胃癌术后肠内营养支持对患者人体成分及能量代谢变化的影响
| 作者: |
2黄迎春,
2彭南海,
2刘思彤
2 南京军区南京总医院普通外科研究所，南京 210000) |
| 通讯: |
李雪娇
Email: 475003853@qq.com 黄迎春 Email: 475003853@qq.com 彭南海 Email: 475003853@qq.com 刘思彤 Email: 475003853@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.11.019 |
摘要
目的：了解肠内营养支持治疗对胃癌术后患者人体成份变化及能量代谢的影响。方法：前瞻性选取2013年2月至2015年7月南京军区南京总医院收治的182例胃癌术后患者，其中140例患者于出院前开始对其实施肠内营养及相关护理，42例患者未接受肠内营养支持。两组患者均由营养支持护理小组术后随访并利用人体成分分析仪及间接能量代谢仪进行人体成分分析及能量代谢的测定，观察比较患者接受营养支持后骨骼肌、体脂肪、蛋白质、体重BMI等指标的变化。结果：经过3个月的肠内营养支持，治疗组复查胃癌术后患者的体重、BMI、骨骼肌、蛋白质、体细胞量(body cell mass，BCM)、身体细胞内液(intracellular water，ICW)明显较肠内营养治疗前高，患者浮肿度有所降低，差异有统计学意义(P<0.05)。而呼吸商(respiratory quotient，RQ)、体脂肪、上臂周围(upper arm，AC)、上臂无脂周围(arm around fat-free，AMC）、骨矿物质含量(bone mineral content，BMC)、细胞外液(extracellular water，ECW)较治疗差异无统计学意义(P>0.05)；胃癌术后肠内营养支持的140例患者与胃癌术后无经过营养支持治疗的42例患者相比较，其体重、骨骼肌、蛋白质、上臂周围(AC)、上臂无脂周围(AMC)明显较无营养支持组高，差异有统计学意义(P<0.05)。而BMI、体脂肪、体细胞量、骨矿物质含量(BMC)、细胞内液(ICW)、细胞外液(ECW)、浮肿度差异无统计学意义(P>0.05)。结论：经过3个月的肠内营养支持护理后，胃癌术后患者的能量代谢及人体成分各项指标较治疗前有明显改善。
关键词：
肠内营养支持护理
胃癌术后
静息能量消耗
人体成分分析
Patients with gastric cancer postoperative enteral nutrition support on body composition and the change of energy metabolism
DOI: 10.3978/j.issn.2095-6959.2015.11.019
Abstract
Objective: To investigate the effect of enteral nutrition support on the changes of body element and energy metabolism in patients with gastric cancer after operation. Methods: Prospective selected from 182 cases of postoperative patients with gastric cancer, including 140 patients accept enteral nutrition and related nursing care before discharge and 42 patients who did not receive enteral nutrition support from February 2013 to July 2015. Two groups of patients after surgery followed up by the nutritional support of nursing team, and use the human body composition analyzer and indirect energy metabolism instrument measuring body composition, observed and compared patients after accept nutrition support their muscle, body fat, protein, weight, BMI changes. Results: After 3 months of enteral nutrition support, treatment group to check the patients’ weight, BMI, skeletal muscle, protein, body cell mass (BCM), intracellular water (ICW) is significantly higher than before enteral nutrition therapy, patients with edema degree reduced, the difference was statistically significant (P<0.05), and respiratory quotient (RQ), body fat, around the upper arm (AC), upper arm around fat-free (AMC), bone mineral content (BMC), extracellular water (ECW) there was no statistically significant difference compared with treatment (P>0.05); 140 cases receiving enteral nutrition support after gastric cancer patients with no after nutritional support treatment of 42 cases of postoperative gastric cancer patients compared, its weight, skeletal muscle, protein, around the upper arm (AC), upper arm around fat-free (AMC) significantly less high nutritional support group, the difference was statistically significant (P<0.05). And BMI, body fat, body cell mass and bone mineral content (BMC), intracellular water (ICW) and extracellular water (ECW), there was no statistically significant difference degree of swelling (P>0.05). Conclusion: After 3 months of enteral nutrition support, postoperative gastric cancer patients of energy metabolism and body composition than before treatment significantly were improved.