目的评价肝癌患者肝切除术后使用低氮低热量营养支持对患者术后恢复的影响。方法符合入选标准的肝癌肝部分切除患者54例,随机进入研究组和对照组。研究组(n=29)术后第一天开始肠外营养(PN)按非蛋白热量15(14—16)kcal·k1-1·d1-1、氮0.12(0.11~0.13)g·kg-1·d-1。剂量由“3L”袋无菌配置标准提供,对照组(n=25)按非蛋白热量25(23—27)kcal·k1-1·d1-1、氮0.20(0.19~0.21)g·kg-1·d-1剂量由“3L”袋无菌配置标准提供。两组患者术后连续5d以上经“外周静脉”或“经外周中心静脉”提供肠外营养(PN)支持。观察两组肝功能、肾功能、血脂、血糖、静脉炎、全身炎症反应综合征(SIRS)、术后住院时间、治疗费用等情况。结果与传统PN组相比,低氮低热量肠外营养支持对患者术后肝功能恢复有利,有利于血糖水平控制,术后并发症发生率相仿,能够缩短住院时间和减少住院费用。结论肝癌、肝硬化患者术后行低氮低热量肠外营养支持是一种安全有效的治疗方法。
Objective Objectives : To observe the role of hypocaloric nutrition support after liver resection in patients with hep- atocelluar carcinoma. Methods 57 cases after heptectomy surgical procedure were randomly assigned into 2 groups : hypocaloric group (rt =29), receiving peripheral parenteral nutrition support with 15( 14 - 16)kcal·k1-1·d1-1 and nitrogen 0. 12(0. 11 -0. 13)g·kg-1·d-1 in regular "3 liter bag", and contral group(n =28) receiving calorie of 25(23 ~27)kcal·k1-1·d1-1 and nitrogen 0. 20 (0. 19 - 0. 21 ) g·kg-1·d-1 in regular "3 liter bag". Postoperative liver function, plasma proteins and body composition. Re- suits Liver functions was found to be improved, hyperglycemia was controlled more softly, postoperative complications was equal, and total post-operative cost was saved. Conclusion The hypocaloric nutrition support is an effective method for postoperative nutrition support in patients after bepotectomy with liver cancer.