ObjectiveTo evaluate the value of omega-3 fish oil fat emulsion in parenteral nutrition support after radical resection of gastric cancer patients.MethodsThe clinical data of 80 patients in Tongling Peopl’s Hospital undergoing radical resection of gastric cancer from March 2018 to September 2019 were enrolled by retrospective method. Of them, 40 patients were treated with routine parenteral nutrition (control group) and 40 patients were treated with extra 100 mL omega-3 fish oil fat emulsion after operation (observation group). Nutritional and stress indicators included blood total albumin (TP), albumin (ALB), c-reactive protein (CRP), and procalcitonin (PCT) on one day before operation, and 1st, 3rd, and 7th day after operation were collected. The collected indexes of liver function included blood cholesterol (CHO), triglyceride (TG), total bilirubin (TBIL), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (γ-GT) on one day before operation, and 3rd and 7th days after operation.Results① Nutritional indicator. There was no significant differences in TP and ALB levels between the two groups on one day before operation, and on the 1st, 3rd, and 7th day after operation (P>0.05). In the same group compared with one day before operation, the average TP level of the control group and the observation group decreased on the 1st, 3rd, and 7th day after operation (P<0.05), and in the control group and the observation group, the ALB level decreased on the 1st day after operation (P<0.05), and increased on the 7th day after operation (P<0.05). ② Stress index. There was no significant difference in CRP and PCT levels between the two groups on one day before and one day after operation (P>0.05), and the CRP and PCT levels in the observation group were lower than those in the control group on the 3rd day and 7th day after operation (P<0.05). Compared with the CRP and PCT levels on the one day before operation, the average CRP and PCT levels in the observation group and the control group increased on the 1st, 3rd, and 7th day after operation (P<0.05). ③ Liver function index. There was no significant differences in CHO, TG, and γ-GT levels between the two groups on one day before operation and the 3rd day after operation (P>0.05), but the above indexes of observation group were lower on the 7th day after operation than those of the control group (P<0.05). There was no significant differences on TBIL, ALT, and ALP levels between the postoperative observation group and the control group (P>0.05). Compared with one day before operation in the same group, there was no significant difference on CHO and ALP levels on 3rd and 7th day after operation in both the observation group and control group (P>0.05). There was no significant differences in TG and TBIL levels in the observation group on 3rd and 7th day after operation (P>0.05), but the TG and TBIL levels in the control group were increased on 7th after operation (P<0.05), and the ALT and γ-GT levels in the observation group and the control group on 7th day after operation were increased in the same group compared with one day before operation (P<0.05).ConclusionParenteral nutrition with omega-3 fish oil fat emulsion do not improve the recent postoperative nutritional status, but reduce the inflammatory stress response and protecte liver function in patients with gastric cancer after operation.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
Objective To investigate the influence on the postoperative recovery for giving either total parenteral nutrition （TPN） or early enteral nutrition (EEN) to patients with gastric cancer after total gastrectomy. Methods Eighty-six patients with gastric cancer undergone total gastrectomy were divided into TPN group (n=31) and EEN group (n=55). Patients in TPN group received TPN support via vena cava (internal jugular vein or subclavian vein), while patients in EEN group received early feeding through the naso-intestinal tube, which was placed during operation, and volume of enteral nutrition (fresubin) was increased daily, full enteral nutrition was expected on day 3-5. Nutrition status after operation, postoperative plasma albumin (Alb), the time of passing gas or stool, the time of oral intake, hospital stay and any postoperative complications were recorded and analyzed. Results There were no significant differences between two groups (Pgt;0.05) in postoperative plasma Alb level, the time of passing gas or stool, postoperative complications rate or hospital stay. However, in the TPN group, the time of oral intake was shorter than that in EEN group (P=0.004). Conclusions Both TPN and EEN are the suitable nutritional methods for patients with gastric cancer after total gastrectomy, and with no detectable difference. For patients with high risk, such as severe malnutrition, naso-intestinal tube should be placed for EEN.
Thirty two surgical patients with liver disease (hepatocelluar carcinoma 16, liver cirrhosis 8, obstructive jaundice 8) were studied. All of them were randomly divided into three groups for administration of different kinds of TPN during the postoperative period [group Ⅰ (TPN without fat emulsion), group Ⅱ (TPN with fat emulsion, 1g/kg body weight/day of fat), group Ⅲ (TPN with fat emulsion 2g/kg body weight/day of fat )]. Their liver function test, glucose, lipid metabolism were examined and compared during the period of TPN. Result: ①TB, ALT and AST decreased in group Ⅱ and group Ⅲ (Plt;0.05), but increased in group Ⅰ (Plt;0.05). ②The blood glucose and insulin levels were normal in group Ⅱ and groupⅢ, but showed hyperglycemia and hyperinsulinemia in group Ⅰ (Plt;0.05). ③The serum lipid, lipoprotein, apoliprotein level and LCAT activity returned to normal 6 days after operation in group Ⅱ (Plt;0.05), but not in group Ⅰ and groupⅢ (Plt;0.05). Conclusion: ①TPN with fat emulsion for surgical patients with liver disease can make more improvement on hepatic functions than TPN without fat emulsion. ②1g/kg body weight/day of fat dosage may be suitable for the patients during the period of postoperative TPN.
【Abstract】ObjectiveTo explore the mechanisms of anabolism intensified by recombination human growth hormone (GH) on the basis of total parenteral nutrition (TPN) during postoperative in gastrointestinal carcinoma patients. MethodsNinety-four gastrointestinal carcinoma patients undergone operation were randomly divided into TPN group and TPN+GH group. The levels of TNF-α, IL-1, IL-6 and CRP were detected in the first, third, seventh postoperative day. ResultsThe levels of TNF-α, IL-1, IL-6 and CRP were significantly lower in TPN+GH group than those in the TPN group at the first, third, seventh postoperative day （P＜0.01）. The levels of TNF-α, IL-1, IL-6 and CRP were significantly higher at the indicated time of postoperative days than the pre-operative days in the two groups (P＜0.01）. ConclusionBy inhibiting TNF-α, IL-1, IL-6 and CRP production in gastrointestinal carcinoma patients undergone operation and blocking high catabolism induced by inflammatory cytokines, GH promotes the synthesis of anabolism.
ObjectiveTo understand the related application and future development trend of enteral nutrition (EN) support in the treatment of patients with malignant obstructive jaundice (MOJ), and provide a reference for clinical decision-making. MethodThe relevant literatures on EN support in the treatment of MOJ at home and abroad in recent years were reviewed. ResultsIn the treatment of patients with MOJ, EN support treatment could maintain the integrity of intestinal mucosal barrier function, reduce intestinal permeability, and reduce bacterial ectopic. At the same time, it could effectively improve the immune function of patients, promote the recovery of liver function, reduce the stress response of patients, reduce the incidence of complications, accelerate the postoperative recovery of patients and shorten the hospitalization time of patients. ConclusionEN support is an important measure in treatment of MOJ, which can obviously promote recovery of patients.
ObjectiveTo systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsA total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. ConclusionCurrent evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo compare the impact of early enteral nutrition (EN) and parenteral nutrition (PN) on the postoperative efficacy of esophageal cancer through meta-analysis of relevant randomized controlled trial (RCT).MethodsPubMed, Medline, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine disc (CBMdisc) were searched by computer from inception to April 2018 to identify potential RCT which assessed clinical efficacy between EN and PN for postoperative patients with esophageal cancer. According to the inclusion and exclusion criteria, two researchers independently screened and evaluated literature. Meta-analysis was performed by RevMan 5.3 software.ResultsA total of 30 RCT studies were selected, including 3 969 patients. Meta-analysis results showed that: there was a significant difference between EN and PN in postoperative anastomotic fistulas (I2=0%, OR=0.67, 95%CI 0.45-0.99, P=0.04), postoperative pulmonary infections (I2=0%, OR=0.42, 95%CI 0.32-0.55, P<0.000 1), postoperative albumin levels (I2=38%, MD=0.78, 95%CI 0.51-1.06, P<0.000 01),time of first anal exhaust after operation (I2=0%, MD=–23.16, 95%CI –25.16-21.16, P<0.000 01) and postoperative incision infection (I2=0%, RR=0.36, 95%CI 0.21-0.64, P=0.000 5).ConclusionCompared with PN, early EN can significantly reduce the incidence of major postoperative complications and shorten the time of first anal exhaust after surgery. In addition, EN is superior to PN in improving nutritional status, increasing weight and reducing costs and side effects.
ObjectiveTo explore influence of different nutritional approaches on liver function in patients after esophagectomy.
MethodsA total of 160 patients with esophageal cancer who underwent surgical treatment were divided into a enteral nutrition (EN) group and a total parenteral nutrition (TPN) group according to different medical staff. There were 80 patients in each group. Two and 7 days postoperatively, albumin (ALB), prealbumin (PA), alanine aminotransferase (ALT) and total bilirubin (TB) of the 2 groups were examined to evaluate liver function.
ResultsAbnormities in liver function (ALB, PA, ALT, TB) was common phenomenon in esophageal cancer patients, but there was no statistical difference in ALB, PA, ALT, TB on the 2nd postoperative day between the EN group and the TPN group (P > 0.05). On the 7th postoperative day, liver functions were improved than those on the 2nd postoperative day in the two groups. And frequencies of liver function abnormity in the EN group were significantly lower than those in the TNP group (P < 0.05).
ConclusionCompared with TPN, EN has advantages in facilitating hepatic protein synthesis and recovery of liver function after esophagectomy.
Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
