Objective: To compare the prognosis of elderly patients with gastric and colorectal cancer treated with different nutritional support methods. Methods: Elderly patients with gastrointestinal tumors who received surgical treatment in Beijing Hospital from January 2019 to June 2020 were retrospectively included and divided into malnourished group and non-malnourished group according to the Global Leadership Initiative on Malnutrition (GLIM). The patients were divided into parenteral nutrition (PN) group, enteral nutrition (EN) group and enteral+parenteral nutrition (EN+PN) group according to the nutritional support. The prognosis of patients with different nutritional support treatment was compared. Results: A total of 426 elderly patients with gastric and colorectal tumors underwent surgical treatment were included, including 287 males and 139 females, aged 65-91 (72±6) years. There were 186 cases in malnourished group and 240 cases in non-malnourished group. A total of 257 patients received nutritional support therapy, including 108 cases in PN group, 48 cases in EN group and 101 cases in EN+PN group. The body mass index (BMI) of malnutrition group was lower than that of non-malnutrition group [(20.5±3.4) vs (23.7±2.8) kg/m2, P<0.001], and the score of nutritional risk screening 2002 (NRS 2002) [M (Q1, Q3)] was higher than that of non-malnutrition group [4 (4, 5) vs 2 (2, 3) points, P<0.001]. The total hospitalization time of patients in EN group was shorter than that in PN group and EN+PN group [(11.9±4.0) vs (16.5±6.5) and (19.2±7.1) d, all P<0.001]. The total hospitalization time in PN group was shorter than that in EN+PN group [(16.5±6.5) vs (19.2±7.1) d, P=0.005]. The total incidence of complications in EN group was lower than that in PN group [0 vs 9.3% (10/108), P=0.030] and EN+PN group [0 vs 19.8% (20/101), P<0.001]. The incidence of total complications in PN group was lower than that in EN+PN group [9.3% (10/108) vs 19.8% (20/101), P=0.030]. Conclusion: Among the three nutritional supportive treatment modalities: EN, PN, and EN+PN, patients receiving EN support treatment have a shorter total hospitalization time and a lower complication rate.
目的： 比较接受不同营养支持治疗方式的胃和结直肠肿瘤老年患者预后。 方法： 回顾性纳入2019年1月至2020年6月北京医院接受手术治疗的胃肠肿瘤老年患者，应用全球营养组织倡议的营养不良诊断（GLIM）标准分为营养不良组及无营养不良组；根据患者接受的营养支持方式分为：肠外营养（PN）组、肠内营养（EN）组以及肠内+肠外（EN+PN）组，比较接受不同的营养支持治疗方式的患者预后。 结果： 共纳入426例接受手术治疗的老年胃与结直肠肿瘤患者，男287例，女139例，年龄65~91（72±6）岁。营养不良组186例，无营养不良组240例；接受营养支持治疗的共257例，PN组108例，EN组48例，EN+PN组101例。营养不良组的体质指数（BMI）低于无营养不良组［（20.5±3.4）比（23.7±2.8）kg/m2，P<0.001］，营养风险筛查2002（NRS 2002）评分［M（Q1，Q3）］高于无营养不良组［4（4，5）比2（2，3）分，P<0.001］。EN组总住院时间低于PN组和EN+PN组［（11.9±4.0）比（16.5±6.5）和（19.2±7.1）d，均P<0.001］；PN组总住院时间低于EN+PN组［（16.5±6.5）比（19.2±7.1）d，P=0.005］。EN组总并发症发生率低于PN组［0比9.3%（10/108），P=0.030］和EN+PN组［0比19.8%（20/101），P<0.001］；PN组总并发症发生率低于EN+PN组［9.3%（10/108）比19.8%（20/101），P=0.030］。 结论： 在EN、PN、EN+PN三种营养支持治疗方式中，接受EN支持治疗的患者的总住院时间更短，并发症发生率更低。.