高热量营养支持对胃造瘘术后ALS患者营养状况及生存率的影响观察

摘要/Abstract

摘要： 目的：观察高热量营养支持对胃造瘘术后肌萎缩侧索硬化症（ALS）患者营养状况及生存率的影响。方法：选择2019年1～12月在我院行经皮胃造瘘术的ALS患者30例作为研究对象，采用随机数字表法分为常规喂食组（对照组）、常规喂食+全安素高热量营养组（研究组），每组各15例。所有患者均定期随访，比较两组患者术后1、3、6个月体重增加情况；比较两组患者术前、术后1、3、6个月血清转铁蛋白、白蛋白水平，术前、术后6个月血清胆固醇（TC）、甘油三脂（TG）水平；记录两组患者术后3、6、12个月生存率。结果：研究组患者术后1、3、6个月体重较术前增加幅度分别为（1.073±0.115）、（1.808±0.203）、（2.339±0.262） kg，对照组患者术后1、3、6个月体重较术前增加幅度分别为（0.704±0.104）、（1.246±0.197）、（1.522±0.241） kg，研究组患者术后1、3、6个月体质量增加幅度均大于对照组（P＜0.05）。两组患者术后1、3、6个月血清转铁蛋白、白蛋白水平均高于术前（P＜0.05），且研究组患者术后1、3、6个月血清转铁蛋白、白蛋白水平均高于对照组（P＜0.05）。研究组患者术后6个月血清TC、TG水平均高于术前（P＜0.05），且高于对照组患者术后6个月TC、TG水平（P＜0.05）。研究组术后3、6个月生存率分别为100.00%、93.33%，对照组同期分别为100.00%、86.67%，差异均无统计学意义(P＞0.05)。研究组术后12个月生存率为86.67%，高于对照组的66.67%（P＜0.05）。结论：全安素高热量营养支持可改善胃造瘘术后ALS患者的营养状况和血脂水平，进一步增加体重并提高生存率。

关键词: font-size:medium, ">font-size:medium, ">肌萎缩侧索硬化症；高热量营养支持；胃造瘘术；转铁蛋白；白蛋白；生存率

Abstract: Objective： To observe the effect of high-calorie nutritional support on the nutritional status and survival rate of patients with amyotrophic lateral sclerosis (ALS) after gastrostomy. Methods： 30 patients with ALS who underwent percutaneous gastrostomy in our hospital from January 2019 to December 2019 were selected as the research objects. The patients were randomly divided into the conventional feeding group (control group)， and conventional feeding+Ensure complete high-calorie nutrition group (study group) according to random number table， with 15 cases in each group. All patients were followed up regularly and the increase of body weight of the two groups of patients at 1， 3， and 6 months after operation were compared. The serum transferrin level and albumin level of the two groups of patients before operation， 1， 3， and 6 months after operation were compared， and the survival rates of the two groups at 3， 6， and 12 months after operation were recorded. Results： At 1 month， 3 months， and 6 months after operation， the body weight of patients in the study group increased （1.073±0.115），（1.808±0.203），（2.339±0.262） kg respectively compared with that before operation， and the patients in the control group increased (0.704±0.104)，（1.246±0.197），（1.522±0.241）kg compared with that before operation. The body weight increase of the study group at 1， 3， and 6 months after operation was greater than that of the control group (P<0.05). The serum transferrin and albumin levels of the two groups of patients at 1， 3， and 6 months after the operation were higher than those before the operation. The serum transferrin and albumin levels of the patients in the study group were higher than those of the control group at 1， 3， and 6 months after the operation(P<0.05). The serum TC and TG levels of patients in the study group at 6 months after operation were higher than those before operation (P<0.05)， and higher than those in the control group at 6 months after operation (P<0.05). The survival rates of the study group were 100.00% and 93.33% at 3, 6 months after operation， and the survival rates of the control group were 100.00% and 86.67% at 3, 6 months after operation， and the difference was not statistically significant (P>0.05). The 12 months survival rate in the study group after operation was 86.67%， which was higher than the 66.67% in the control group (P<0.05). Conclusion： Ensure complete high-calorie nutrition can improve the nutritional status and blood lipid levels of ALS patients after gastrostomy， further increase body weight and improve survival rate.
[Key Words]

Key words: Amyotrophic lateral sclerosis, High-calorie nutritional support, Gastrostomy, Transferrin, Albumin, Survival rate

中图分类号:

王赛博, 曹军, 苑天文, 何阳, 周兴, 孔鹏, 闫壁松. 高热量营养支持对胃造瘘术后ALS患者营养状况及生存率的影响观察[J]. 中国医药导刊, 2021, 23(9): 657-661.

WANG Saibo, CAO Jun, YUAN Tianwen, HE Yang, ZHOU Xing, KONG Peng, YAN Bisong. Effects of High-calorie Nutritional Support on Nutritional Status and Survival Rate of ALS Patients after Gastrostomy[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(9): 657-661.

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