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比较上消化道狭窄患者经鼻空肠营养与静脉营养补充的效果及营养不良的危险因素分析。

Comparison of nasojejunal nutrition and intravenous nutrition supplementation in patients with upper gastrointestinal tract strictures and analysis of risk factors for malnutrition.

机构信息

Department of radiology, Peking University First Hospital-Miyun Hospital, Beijing, China.

出版信息

Medicine (Baltimore). 2024 Jul 5;103(27):e38820. doi: 10.1097/MD.0000000000038820.

Abstract

This study examines the effectiveness of nasojejunal and intravenous nutrition in supplementing nutrition for patients with upper gastrointestinal (GI) strictures and analyzes the risk factors associated with malnutrition to provide references for clinical nutrition strategies. A retrospective analysis was conducted on 71 patients with upper GI strictures caused by esophageal and gastric cancers, who received nutritional support from January 2015 to January 2023. Out of these, 53 patients had complete baseline and follow-up data. We collected general clinical and perioperative data for comparison of the efficacy between nasojejunal nutrition and intravenous nutrition. Risk factors for malnutrition were analyzed using univariate and multivariate logistic regression. Malnutrition occurred in 24.53% (13/53) of the patients with upper GI strictures. The incidence of malnutrition was 6.06% (2/33) in the nasojejunal nutrition group compared to 55.00% (11/20) in the intravenous nutrition group, with a statistically significant difference (P < .001). Univariate and multivariate regression analyses identified diabetes (P < .001), initial blood K (P = .011), pathological staging (P < .001), and pathological grading (P < .001) as risk factors for malnutrition in patients with upper GI strictures. Diabetes (P = .028), initial blood K (P = .018), and pathological staging (P = .011) were found to be independent risk factors. Nasojejunal nutrition results in a lower incidence of malnutrition compared to intravenous nutrition in patients with upper GI strictures. Diabetes, initial blood K, pathological staging, and pathological grading are risk factors for malnutrition, with diabetes, initial blood K, and pathological staging serving as independent risk factors.

摘要

本研究旨在探讨鼻空肠与静脉营养在上消化道(GI)狭窄患者中的营养补充效果,并分析与营养不良相关的危险因素,为临床营养策略提供参考。回顾性分析了 2015 年 1 月至 2023 年 1 月间因食管癌和胃癌导致上 GI 狭窄的 71 例患者的营养支持情况,其中 53 例患者具有完整的基线和随访资料。比较鼻空肠营养与静脉营养的疗效,收集一般临床和围手术期数据。采用单因素和多因素 logistic 回归分析营养不良的危险因素。53 例上 GI 狭窄患者中,营养不良发生率为 24.53%(13/53)。鼻空肠营养组营养不良发生率为 6.06%(2/33),静脉营养组为 55.00%(11/20),差异有统计学意义(P<0.001)。单因素和多因素回归分析发现,糖尿病(P<0.001)、初始血钾(P=0.011)、病理分期(P<0.001)和病理分级(P<0.001)是上 GI 狭窄患者营养不良的危险因素。糖尿病(P=0.028)、初始血钾(P=0.018)和病理分期(P=0.011)是营养不良的独立危险因素。与静脉营养相比,鼻空肠营养在上 GI 狭窄患者中营养不良发生率较低。糖尿病、初始血钾、病理分期和病理分级是营养不良的危险因素,糖尿病、初始血钾和病理分期是独立危险因素。

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