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目的观察比较围手术期使用脂肪乳及白蛋白对结肠癌手术患者营养的疗效。方法62例结肠癌手术患者随机分为脂肪乳组(31例)和白蛋白组(31例),脂肪乳组术前及术后7d每日输注中链脂肪乳500ml,共14d,白蛋白组术前及术后7d每日输注人血白蛋白20g,共14d。术前、术后3d、术后7d抽静脉血测白蛋白,前白蛋白,转铁蛋白;术后1～7d每天收集24h尿、粪和引流液,测定氮量,计算氮平衡;并记录两组患者的术后并发症,统计住院费用。结果结肠癌围手术期补充脂肪乳或白蛋白均能提高血浆白蛋白水平,作为营养评价敏感指标的血前白蛋白,转铁蛋白水平两组患者无显著差异(P>0.05),术后每日氮平衡及累积氮平衡两组间无显著差异(P>0.05),两组术后并发症的发生率亦无显著差异(P>0.05)。相反,白蛋白的应用增加了住院费用,白蛋白组明显高于脂肪乳组(P<0.01)。结论在结肠癌围手术期肠外营养支持时,采取脂肪乳治疗可取到白蛋白治疗所能纠正低蛋白血症及负氮平衡的作用,从而达到取得节省费用的目的。
Objective To compare the efficacy of perioperative use of fat emulsion and albumin in patients with colon cancer surgery. Methods Sixty-two patients undergoing colon cancer surgery were randomly divided into three groups: fatty milk group (31 cases) and albumin group (31 cases). Lipid emulsion group was infused with 500ml of medium-chain fat emulsion daily for 14 days before and 7 days after operation. Total albumin Preoperative and postoperative 7d daily infusion of human serum albumin 20g, a total of 14d. Preoperative, postoperative 3d, 7d after venous pumping venous blood albumin, prealbumin, transferrin; 1 ~ 7d postoperative day collection of urine, feces and drainage 24 hours, measured nitrogen content, and calculate the nitrogen balance; Postoperative complications of two groups of patients, statistical hospital costs. Results Lipid albumin or albumin supplementation during perioperative period of colon cancer could increase plasma albumin levels. There was no significant difference between the two groups (P> 0.05), preoperative serum albumin and transferrin level (P> 0.05) Nitrogen balance and cumulative nitrogen balance were not significantly different between the two groups (P> 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). In contrast, the use of albumin increased hospital costs, albumin was significantly higher than the fat emulsion group (P <0.01). Conclusions In the perioperative period of parenteral nutrition for colorectal cancer, lipoprotein therapy can be used to correct hypoproteinemia and negative nitrogen balance in order to save money.