Department of Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China.
World J Gastroenterol. 2011 Apr 7;17(13):1779-86. doi: 10.3748/wjg.v17.i13.1779.
To review the application of nutrition support in patients after surgery for colorectal cancer, and to propose appropriate nutrition strategies.
A total of 202 consecutive surgical patients admitted to our hospital with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements of Nutrition Risk Screening 2002, were enrolled in our study. Laboratory tests were performed to analyze the nutrition status of each patient, and the clinical outcome variables, including postoperative complications, hospital stay, cost of hospitalization and postoperative outcome, were analyzed.
The "non-risk" patients who did not receive postoperative nutrition support had a higher rate of postoperative complications than patients who received postoperative nutrition support (2.40 ± 1.51 vs. 1.23 ± 0.60, P = 0.000), and had a longer postoperative hospital stay (23.00 ± 15.84 d vs. 15.27 ± 5.89 d, P = 0.009). There was higher cost of hospitalization for patients who received preoperative total parenteral nutrition (TPN) than for patients who did not receive preoperative TPN (62 713.50 ± 5070.66 RMB Yuan vs. 43178.00 ± 3596.68 RMB Yuan, P = 0.014). Applying postoperative enteral nutrition significantly shortened postoperative fasting time (5.16 ± 1.21 d vs. 6.40 ± 1.84 d, P = 0.001) and postoperative hospital stay (11.92 ± 4.34 d vs. 15.77 ± 6.03 d, P = 0.002). The patients who received postoperative TPN for no less than 7 d had increased serum glucose levels (7.59 ± 3.57 mmol/L vs. 6.48 ± 1.32 mmol/L, P = 0.006) and cost of hospitalization (47 724.14 ± 16 945.17 Yuan vs. 38 598.73 ± 8349.79 Yuan, P = 0.000). The patients who received postoperative omega-3 fatty acids had a higher rate of postoperative complications than the patients who did not (1.33 ± 0.64 vs. 1.13 ± 0.49, P = 0.041). High level of serum glucose was associated with a high risk of postoperative complications of infection.
Appropriate and moderate nutritional intervention can improve the postoperative outcome of colorectal cancer patients.
回顾结直肠癌患者术后营养支持的应用，并提出适宜的营养策略。
选取 2010 年 1 月至 7 月期间我院收治的 202 例结肠癌或直肠癌手术患者，符合 2002 年营养风险筛查标准，进行实验室检查分析患者的营养状况，分析术后并发症、住院时间、住院费用及术后结局等临床结局变量。
未接受术后营养支持的“非风险”患者术后并发症发生率高于接受术后营养支持的患者（2.40 ± 1.51 比 1.23 ± 0.60，P = 0.000），术后住院时间也更长（23.00 ± 15.84 d 比 15.27 ± 5.89 d，P = 0.009）。接受术前全肠外营养（TPN）的患者住院费用高于未接受术前 TPN 的患者（62713.50 ± 5070.66 元比 43178.00 ± 3596.68 元，P = 0.014）。术后肠内营养的应用显著缩短了术后禁食时间（5.16 ± 1.21 d 比 6.40 ± 1.84 d，P = 0.001）和术后住院时间（11.92 ± 4.34 d 比 15.77 ± 6.03 d，P = 0.002）。接受术后 TPN 治疗不少于 7 d 的患者血糖水平升高（7.59 ± 3.57 mmol/L 比 6.48 ± 1.32 mmol/L，P = 0.006），住院费用增加（47724.14 ± 16945.17 元比 38598.73 ± 8349.79 元，P = 0.000）。接受术后ω-3 脂肪酸的患者术后并发症发生率高于未接受者（1.33 ± 0.64 比 1.13 ± 0.49，P = 0.041）。高血糖水平与术后感染并发症的高风险相关。
适当适度的营养干预可改善结直肠癌患者的术后结局。
