| liyan. Difference in the effects of three nutritional pathways on postoperative rehabilitation in patients with gastric cancer and type 2 diabetes mellitus. Oncol Transl Med, 2022, 8: 226-231. |
| 三种营养路径对老年胃癌合并2型糖尿病患者术后康复影响的前瞻性研究 |
| Difference in the effects of three nutritional pathways on postoperative rehabilitation in patients with gastric cancer and type 2 diabetes mellitus |
| Received:October 16, 2021 Revised:October 15, 2022 |
| DOI：10.1007/s10330-021-0529-9 |
| 中文关键词: 胃癌；2型糖尿病；肠内营养；肠外营养 |
| 英文关键词: gastric cancer; type 2 diabetes mellitus; enteral nutrition; parenteral nutrition |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨三种营养路径对胃癌合并2型糖尿病（T2DM）的老年患者术后康复的影响，为临床合理选择提供依据。方法：收集120例胃癌合并T2DM的老年患者为研究对象，将患者随机分为部分肠外营养组（PPN）、早期肠内营养组（EEN）及糖尿病专用肠内营养乳剂组（DEN）。从营养学指标、血糖水平、炎症控制及围手术期指标等方面比较三种营养方式的差异。结果：（1）术前及术后第一天，三组患者的营养学指标无明显差异（P＞0.05）。术后第四天，ENN组与DEN组的总蛋白水平明显高于PPN组（P＜0.05），其他营养学指标无差异（P＞0.05）。术后第十天，DEN组BMI、LYM、总蛋白、前-白蛋白均明显高于PPN组（P＜0.05）。（2）术后第4d，ENN组与DEN组的空腹血糖无明显差异（P＞0.05），但均明显低于PNN组（P＜0.05）。术后第10d，DEN组的空腹血糖、餐后2h血糖均明显小于PPN组，但与ENN组无明显差异（P＞0.05）。（3）术后第4d、第10d，DEN组的CRP水平显著较低（P＜0.05）。（4）PPN组、ENN组、DEN组患者的并发症发生率分别为25.0%(10/40)、10.0%(4/40)、5.0%(2/40)，PPN组患者的并发症发生显著较高。但3组患者的围术期指标，包括术后住院时间、术后排气时间、并发症类型构成等均无明显差异（P＞0.05）。结论：对行手术治疗的胃癌合并T2DM老年患者而言，肠内营养更利于术后恢复，且糖尿病专用肠内营养乳剂比常规营养液更能有效稳定患者血糖、降低炎症水平。 |
| 英文摘要: |
| Objective To explore the difference in the effects of three nutritional pathways on the rehabilitation of
patients with gastric cancer and diabetes mellitus after operation.
Methods Overall, 120 patients were randomly divided into the partial parenteral nutrition (PPN), early
enteral nutrition (EEN), and diabetes mellitus special enteral nutritional emulsion (DEN) groups. The
differences in the effects of three nutritional modes were compared.
Results (1) On postoperative day four, the total protein level in the EEN and DEN groups was significantly
higher than that in the PPN group (P < 0.05). On postoperative day ten, body mass index, lymphocyte
count, total protein level, and pre-albumin level in the DEN group were significantly higher than those in
the PPN group (P < 0.05). (2) On postoperative day four, there was no significant difference in the fasting
blood glucose level between the EEN and DEN groups (P > 0.05), but this level was significantly lower
than that in the PPN group (P < 0.05). On postoperative day ten, fasting and postprandial blood glucose
levels in the DEN group were significantly lower than those in the PPN group. (3) On postoperative day
four, the C-reactive protein level in the DEN group was significantly lower than that in the other groups (P
< 0.05). (4) The incidence rates of complications in the PPN, EEN, and DEN groups were 25.0%, 10.0%,
and 5.0%, respectively. The incidence of complications in the PPN group was significantly higher than that
in the other groups. However, there was no significant difference in perioperative indexes among the three
groups (P > 0.05).
Conclusion Enteral nutrition is more conducive to the recovery of patients with gastric cancer and type
2 diabetes mellitus after operation; the special enteral nutrition emulsion for diabetes mellitus is more
effective than the conventional nutrition solution in stabilizing blood sugar levels and reducing the degree
of inflammation. |
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