Hioki K, Nishi M, Yamamoto M
Nihon Geka Gakkai Zasshi. 1984 Sep;85(9):974-8.
In this study therapeutic effect of total parenteral nutrition (TPN) for the patients undergoing total gastrectomy was evaluated and following results were obtained. Both incidence and cure rate of anastomotic leakage after total gastrectomy had markedly improved, in spite of increased resection rate and curative operation for the patients with advanced gastric cancer by introducing TPN routinely to the nutritional management. It is important to maintain serum albumin level above 3.0 g/dl to give enough calories and protein (40-50 kcal/kg/day). TPN using a combined carbohydrate solution such as the ratio for glucose, fructose, xylitol (4: 2: 1) seems to have a beneficial effect on the patients with surgical diabetes status. It is suggested that serum albumin is a most promising parameter in nutritional assessment of the preoperative period. But in the early postoperative period, rapid turnover protein such as prealbumin might be more accurate parameter. TPN during chemotherapy as an adjunct to surgery leads to diminished morbidity, and possibly to prolonged survival time in the patients undergoing gastrectomy for gastric cancer.
本研究评估了全胃肠外营养（TPN）对全胃切除患者的治疗效果，并得出以下结果。尽管通过将TPN常规引入营养管理，晚期胃癌患者的切除率和根治性手术有所增加，但全胃切除术后吻合口漏的发生率和治愈率均有显著改善。将血清白蛋白水平维持在3.0 g/dl以上以提供足够的热量和蛋白质（40 - 50 kcal/kg/天）很重要。使用葡萄糖、果糖、木糖醇比例为4:2:1的复合碳水化合物溶液进行TPN，似乎对外科糖尿病患者有有益作用。提示血清白蛋白是术前营养评估中最有前景的参数。但在术后早期，前白蛋白等快速周转蛋白可能是更准确的参数。化疗期间的TPN作为手术的辅助手段，可降低胃癌胃切除患者的发病率，并可能延长其生存时间。
