目的 探讨全程综合营养管理在老年肝癌载药微球栓塞术(DEB-TACE)患者中的应用效果。 方法 将 2019 年 4 月至 2021 年 4 月在开滦总医院肝胆外科和老年病科住院的肝癌行 DEB-TACE 术的老年患者作为研究对象,将实施全程综 合营养管理前 2019 年 4 月至 2020 年 4 月的 48 例为对照组,实施全程综合营养管理后 2020 年 5 月至 2021 年 4 月的 56 例 为试验组,对照组病例脱落 4 例,试验组病例脱落 6 例。 对照组实施肝癌栓塞术术后常规营养治疗,试验组采取全程营养 综合管理模式,回顾性分析在患者入院时、术后 7 d、术后 1 月分别观察患者体质指数( BMI) 、营养风险筛查 2002( NRS 2002) 、营养指标情况、喂养达标率、并发症发生率、患者生活质量。 结果 试验组 BMI、喂养达标率、胃肠道并发症、代谢并 发症、生活质量中的生理状况及功能状况优于对照组,差异有统计学意义(P<0. 05) ;NRS 2002 评分、血红蛋白、白蛋白、总 蛋白、机械并发症、生活质量中的社会家庭状况、功能状况两组差异无统计学意义(P>0. 05) ;术后 1 个月 BMI、白蛋白、总 蛋白、生理状况相对于入院时和术后 7 d 差异有统计学意义(P<0. 05) 。 结论 全程综合营养管理随时间推移能改善老年肝 癌 DEB-TACE 患者营养状况,从而改善患者生存质量。

Objective To explore the application effect of whole course comprehensive nutrition management in elderly patients with liver cancer after drug-eluting beads transcatheter aterial chemoembolization DEB-TACE . Method Taking the elderly patients with liver cancer who underwent DEB-TACE in the Department of hepatobiliary surgery and geriatrics of our hospital from April 2019 to April 2021 as the research object 48 cases in the control group from April 2019 to April 2020 before the implementation of the whole process comprehensive nutrition management 56 cases in the experimental group from May 2020 to April 2021 after the implementation of the whole process comprehensive nutrition management 4 cases in the control group and 6 cases in the experimental group. The control group received routine nutritional treatment after liver cancer embolization and the experimental group adopted the whole process nutritional comprehensive management mode. The patients􀆳 body mass index NRS 2002 score nutritional index feeding standard rate complication rate and quality of life were observed at admission 7 days and 1 month after operation. Result The BMI feeding standard rate gastrointestinal complications metabolic complications physiological and functional status of quality of life in the experimental group were better than those in the control group and the difference was statistically significant P< 0. 05 There was no significant difference in NRS 2002 score hemoglobin albumin total protein mechanical complications social and family status and functional status in quality of life P>0. 05 There were significant differences in BMI albumin total protein and physiological status one month after operation compared with those at admission and seven days after operation P< 0. 05 . Conclusion The whole course comprehensive nutrition management can improve the nutritional status of elderly patients with liver cancer after drug loaded microspheres embolization over time so as to improve the quality of life of patients