营养干预对胃癌合并糖尿病患者围手术期的影响(1)
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【摘要】 目的 观察营养干预对胃癌合并糖尿病患者围手术期疗效及营养状况的影响。方法 选择60例胃癌合并糖尿病患者,根据患者及家属对营养支持的接受与否,分为营养组(30例)及对照组(30例)。营养组术前和术后均在营养师的指导下进行规范的经口摄食和肠内营养治疗,而对照组自行控制。分别检测两组患者营养治疗前、术前或术后的平均血糖、胰岛素用量、血糖控制时间、血清白蛋白、前白蛋白及淋巴细胞总数,并观察低血糖的发生率、伤口愈合及并发感染的情况。结果营养干预后,两组患者均可有效降低血糖(P<0.05),降糖效果无明显差异(P>0.05),但营养组胰岛素用量及术前调整时间均少于对照组(P<0.05);营养组血清前白蛋白和淋巴细胞总数的增高、低血糖发生率及伤口一期愈合率均明显优于对照组(P<0.05)。结论 围手术期合理的营养治疗和营养支持可有效控制血糖,改善营养状况,促进病人术后的伤口愈合,防止感染并发症的发生。
【关键词】营养干预;胃癌;糖尿病
【Abstract】ObjectiveTo observe the effect of nutritional intervention on perioperative efficacy and nutritional status in gastric cancer patients with diabetes mellitus.Methods60 cases of gastric cancer patients with diabetes mellitus were divided into nutrition group (30 cases) and control group (30 cases) according to the acceptance of nutritional support of patients and their families. Food intake and enteral nutrition were given in the nutrition group under the guidance of the dietitians before and after operation ,while which were self-controlled in the control group. The average blood glucose, insulin dosage, blood glucose control time, serum albumin, prealbumin and the total number of lymphocytes were detected before treatment, before and after operation,and the incidence of low blood sugar, wound healing and infection were also observed in the two groups.ResultsAfter nutritional intervention, the blood sugar level of all patients was significantly reduced(P<0.05),but there was no significant difference between the two groups(P>0.05). The insulin dosage and blood glucose control time in the nutrition group were less than those in the control group(P<0.05).The rate of serum albumin and the total number of lymphocytes rise, hypoglycemia and primary wound healing in the nutrition group was superior to that in the control group (P<0.05). ConclusionDuring perioperative period,propriate nutrition support helps to control blood glucose and improve nutritional status. And it can facilitate wound healing, prevent patients from infectious complication ......
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