胃癌患者早期增强营养方案后的术后肝功能障碍:一个回顾性观察性研究
Kazuo Kobayashi1, Satoshi Ida2, Masanari Tsuji3
1Department of Pharmacy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-Ku, 3-8-31 Ariake Koto-Ku, ResearchTokyo, 135-8550, Japan. kazuo.sugita@jfcr.or.jp.
Journal of pharmaceutical health care and sciences
|August 5, 2025
概括
胃癌手术后的早期营养支持是安全的,肝功能障碍通常是暂时的. 乙氨基的使用,而不是营养支持,被确定为肝脏问题的关键风险因素.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床营养学 临床营养学
背景情况:
- 手术后肝功能障碍是胃癌手术后的一个已知的并发症.
- 越来越多地使用早期营养支持,包括氨基酸和脂肪乳液.
- 这种早期支持对肝功能的影响需要进一步澄清.
研究的目的:
- 评估术后肝功能障碍的发生率和时间进程.
- 为了确定胃癌手术后肝功能障碍的危险因素.
- 评估早期术后营养支持的安全性.
主要方法:
- 对170名接受了激进胃切除术的患者进行了回顾性观察性研究.
- 通过AST,ALT和T-Bil在特定的术后日和门诊访问中评估肝功能.
- 根据CTCAE v5.0定义的肝功能障碍;使用单变量和多变量方法分析的风险因素.
主要成果:
- AST和ALT水平在术后的第1天和第7天达到峰值,然后下降.
- 乙氨基的使用是术后第7天肝功能障碍的独立风险因素.
- 在早期营养支持 (氨基酸,脂肪乳液) 和肝功能障碍之间没有发现显著的关联.
结论:
- 胃癌患者的术后肝功能障碍通常是暂时的,可以控制.
- 早期用氨基酸和脂肪乳液进行营养支持是安全的,不会损害肝功能.
- 监测肝功能至关重要,特别是在使用乙氨基的患者中.
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