腹膜恶性瘤的细胞还原性手术后的腹腔营养:它应该是常规的管理吗?
Ayman Khan1, Anna Beaumont2, Erin Laing2
1Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Australia.
Clinical nutrition ESPEN
|September 22, 2023
概括
大多数接受细胞削减手术 (CRS) 的患者不需要腹腔营养 (PN). 选择性PN使用没有影响术后体重变化,但营养和操作因素可能预测PN需要.
科学领域:
- 在瘤学瘤学.
- 手术营养是指手术营养.
- 胃肠病学 胃肠病学
背景情况:
- 细胞还原性手术 (CRS) 是一种复杂的腹部手术,用于腹膜恶性瘤,与显著的发病率相关.
- 在CRS之后,优化术后护理,包括营养管理,至关重要.
- 国际协议在CRS后的日常与选择性亲肠道营养 (PN) 管理方面有所不同.
研究的目的:
- 评估在接受CRS的患者中PN的利用率.
- 确定与CRS后PN要求相关的因素.
- 评估选择性PN使用对营养结果的影响.
主要方法:
- 在2015-2020年间,对222名接受了CRS±高温腹腔内化疗 (HIPEC) 的患者进行了回顾性分析.
- 收集的数据包括患者的特征,营养状况,手术细节和术后结果.
- 统计分析涉及千二测试,曼-惠特尼U测试和考克斯回归,以确定PN需求和体重变化的预测因素.
主要成果:
- 29.3%的患者需要术后PN,最常见的原因是术后.
- 预测PN需求的因素包括:手术前白蛋白水平较低,体重显著下降,PCI得分较高,瘤增加,以及术后并发症.
- PN使用与术后体重变化无关.
结论:
- 大多数接受CRS的患者不需要术后PN.
- 营养状况和特定的操作因素可以帮助确定可能需要PN的患者.
- 在这个队列中,选择性PN给药没有影响术后体重变化.
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