| Nowadays, the worldwide incidence and mortality rate ofgastrointestinal oncology are high, as the treatment of advancedgastrointestinal oncology patients are not ideal. Gastrointestinaloncology patients commonly have different levels of protein-caloriemalnutrition, trauma after surgical caused the redistribution ofendogenous nutrients, combined with ban of food insert before and after surgery, chemical therapy and radiotherapy, the body fat reserved and leantissue groups were further depletioned. The continue exists of abovefactors and inadequate nutritional support will lead to cancer cachexiaeventually, a further decline in the body’s immune defense capacity,intestinal barrier structure and function impaired, the incidence ofinfection and mortality rates will increase significantly. Therefore, it’s essential to provied reasonable nutrition support to patients withgastrointestinal oncology.Clinical nutrition support contains total parenteral nutrition (TPN)and enteral nutrition (EN), two pathways of nutritional support have theiradvantages, but also has some limitations. Two nutritional supportpathways in the study of gastrointestinal oncology patients withpostoperative clinical output is more dispersed, and the concluision ofstudys are also different. The first part of this subject is using Metaanalysis method, internalize the literatures which compared enteralnutrition (EN) and total parenteral nutrition (TPN) support ingastrointestinal oncology patients after surgery, evaluated theeffectiveness, security and economy.effect of the two kinds of clinicalnutrition supports.Total Nutrient Admixture (TNA) is always used for TPN support inpatients with gastrointestinal oncology whoes gastrointestinal tractfunction are not yet available in early postoperative period. Due to TNAchemical properties are complicated, variability exist in individuals andneed temporary prepared every day, the irrational energy supply andnutrition drug abuse always existed in clinical used. The second part ofthis subject retrospective analyzed the clinical information ofgastrointestinal cancer patients undergoing surgery treatment， toinvestigate the clinical effect of patients who were intervated by clinical pharmacists’ providing individual TNA.1. Comparison with enteral and parenteral nutritional support ingastrointestinal oncology patient undergoing surgery treatment: AMeta-analysisRetrieval clinical research literatures which compared enteral andparenteral nutrition support to gastrointestinal oncology patientsundergoing surgery treatment on Medline (Pubmed), Embase, and Cochranedatabase. Adopt RevMan5.1to meta-analysis the data. A total of20studieswere included in this article:10studies were meta-analyzed for nutritionindex,16studies were meta-analyzed for complication,10studies weremeta-analyzed for hospital stay. The merger value WMD of TP, TFN, PreALB,ALB and LYM corresponding to2.32、0.13、0.01、1.22and0.01, the mergervalue OR of the postoperative complications incidence is0.74; the mergervalue WMD of the hospital stay is-1.47. The results showed that, comparedwith parenteral nutrition, enteral nutrition nutritional support inpatients with gastrointestinal oncology undergoing surgery treatment caneffectively improve the patients’ nutritional status and reducepostoperative complications, made hospital stay shorter and treatmentcosts lower.2. Clinical Pharmacist’s intervention study of Total nutrition admixturecomposition in gastrointestinal cancer patients undergoing surgerytreatmentRetrospective analyzed the clinical information of87gastrointestinal cancer patients undergoing surgery treatment，dividedthem into two groups. Intervention group (n=23): consultation by clinical pharmacist to provide individual total nutrition admixture composition;control group (n=64): clinical pharmacists are not involved in nutritionsupport. Total serum protein (TP), serum albumin (ALB), prealbumin (PA),lymphocyte counts (LYM), postoperative complications and hospital staywere recorded and compared in both groups. Intervention group nutritionindex in d5after operation was statistically significant higher thanwhich in d1after operation (P＜0.05); The nutrition index was nosignificant difference between intervention group and control group ind1before operation (P＞0.05), while Intervention group nutrition indexin d5after operation is statistically significant higher than controlgroup in d5after operation (P＜0.05); the hospital stay of interventiongroup (10.8±2.2) d is statistically significant lower than control group(14.9±2.4) d (P＜0.05), while the postoperative complications was nosignificant difference between intervention group and control group (P＞0.05). The clinical pharmacists involve in parenteral nutrition supportof gastrointestinal patients undergoing operation and providepharmaceutical care, could improve nutritional status and rehabilitationeffect of patients. |
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