摘要
目的比较接受不同营养支持治疗方式的胃和结直肠肿瘤老年患者预后。方法回顾性纳入2019年1月至2020年6月北京医院接受手术治疗的胃肠肿瘤老年患者,应用全球营养组织倡议的营养不良诊断(GLIM)标准分为营养不良组及无营养不良组;根据患者接受的营养支持方式分为:肠外营养(PN)组、肠内营养(EN)组以及肠内+肠外(EN+PN)组,比较接受不同的营养支持治疗方式的患者预后。结果共纳入426例接受手术治疗的老年胃与结直肠肿瘤患者,男287例,女139例,年龄65~91(72±6)岁。营养不良组186例,无营养不良组240例;接受营养支持治疗的共257例,PN组108例,EN组48例,EN+PN组101例。营养不良组的体质指数(BMI)低于无营养不良组[(20.5±3.4)比(23.7±2.8)kg/m^(2),P<0.001],营养风险筛查2002(NRS 2002)评分[M(Q_(1),Q_(3))]高于无营养不良组[4(4,5)比2(2,3)分,P<0.001]。EN组总住院时间低于PN组和EN+PN组[(11.9±4.0)比(16.5±6.5)和(19.2±7.1)d,均P<0.001];PN组总住院时间低于EN+PN组[(16.5±6.5)比(19.2±7.1)d,P=0.005]。EN组总并发症发生率低于PN组[0比9.3%(10/108),P=0.030]和EN+PN组[0比19.8%(20/101),P<0.001];PN组总并发症发生率低于EN+PN组[9.3%(10/108)比19.8%(20/101),P=0.030]。结论在EN、PN、EN+PN三种营养支持治疗方式中,接受EN支持治疗的患者的总住院时间更短,并发症发生率更低。
Objective To compare the prognosis of elderly patients with gastric and colorectal cancer treated with different nutritional support methods.Methods Elderly patients with gastrointestinal tumors who received surgical treatment in Beijing Hospital from January 2019 to June 2020 were retrospectively included and divided into malnourished group and non-malnourished group according to the Global Leadership Initiative on Malnutrition(GLIM).The patients were divided into parenteral nutrition(PN)group,enteral nutrition(EN)group and enteral+parenteral nutrition(EN+PN)group according to the nutritional support.The prognosis of patients with different nutritional support treatment was compared.Results A total of 426 elderly patients with gastric and colorectal tumors underwent surgical treatment were included,including 287 males and 139 females,aged 65-91(72±6)years.There were 186 cases in malnourished group and 240 cases in non-malnourished group.A total of 257 patients received nutritional support therapy,including 108 cases in PN group,48 cases in EN group and 101 cases in EN+PN group.The body mass index(BMI)of malnutrition group was lower than that of non-malnutrition group[(20.5±3.4)vs(23.7±2.8)kg/m^(2),P<0.001],and the score of nutritional risk screening 2002(NRS 2002)[M(Q_(1),Q_(3))]was higher than that of non-malnutrition group[4(4,5)vs 2(2,3)points,P<0.001].The total hospitalization time of patients in EN group was shorter than that in PN group and EN+PN group[(11.9±4.0)vs(16.5±6.5)and(19.2±7.1)d,all P<0.001].The total hospitalization time in PN group was shorter than that in EN+PN group[(16.5±6.5)vs(19.2±7.1)d,P=0.005].The total incidence of complications in EN group was lower than that in PN group[0 vs 9.3%(10/108),P=0.030]and EN+PN group[0 vs 19.8%(20/101),P<0.001].The incidence of total complications in PN group was lower than that in EN+PN group[9.3%(10/108)vs 19.8%(20/101),P=0.030].Conclusion Among the three nutritional supportive treatment modalities:EN,PN,and EN+PN,patients receiving EN support treatment have a shorter total hospitalization time and a lower complication rate.
作者
陈丽如
李子建
崔红元
程博
唐大年
张岸琦
丁丽丽
朱明炜
Chen Liru;Li Zijian;Cui Hongyuan;Cheng Bo;Tang Danian;Zhang Anqi;Ding Lili;Zhu Mingwei(Department of Clinical Nutrition,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第33期3130-3135,共6页
National Medical Journal of China
基金
国家重点研发计划(2022YFC2010101)
中国医学科学院医学与健康科技创新工程(2021-I2M-C&T-B-094)
中华国际医学交流基金(Z-2017-24-2211)
关键词
胃肠肿瘤
肠外营养
肠内营养
老年
预后
Gastric and colorectal cancer
Parenteral nutrition
Enteral nutrition
Elderly
Prognosis
