摘要：目的探讨根治性胆囊切除术对胆囊癌患者营养水平的影响。方法27例行根治性胆囊切除术的胆囊癌患者，分别于术前和术后第三天、第一周、第二周及第三周测定血清白蛋白、胆固醇、总铁结合量、转铁蛋白、铁、镁、锌浓度。结论术后第三天，所有的营养评估指标均急剧下降(P＜0．01)。术后二～三周，血清白蛋白、镁、锌浓度已恢复到术前水平，但血清铁、转铁球蛋白和血清总铁结合量在术后第三周仍未恢复。结论胆囊癌根治性切除术对患者营养水平的影响是暂时的和可逆转的，患者应补充足量的铁，同时要定期检查血清微量元素水平。

The effect of radical cholecystectomy on nutritional status in patients with gailbladder eareinoma

jIAO Xinyuan,SHI Jinsen,YU Yaoli(The Hepato-biliary Research lab. The First Affiliated Hospitall of Xl'an Medical University, Xi' an 710061)

Abstract：Objective To evaluate the peri-operative sequential changes in patients in nutritional status. Mothods Twenty-seven patients with early gallbladder carcinoma who had undergone radical cholecystectomy were studied. The nutritional assessment were performed preoperatively,on the postoperative day3, 7, 14 and 21. Results All the parameters in nutritional assessment declined greatly by post-operative day 3 (P＜0.01). Most of them returned to the preoperative levels within 2～3 weeks after surgery. However, the serum levels of iron, transferrin and TIBC did not return to normal in the third post-operative week. Conelasions Radical cholecystectomy for early gallbladder carcinoma might have only temporarily effect on the host nutritional parameters returned to the preoperative level within second and third weeks after surgery. An adequate supplementation of iron is needed after the second post-operative week. It is very necessary for monitoring the serum minerals levels after surgery.

Keywords：Gallbladder carcinoma Cholecystectomy Nutrition

参考文献：

［1］Saito T, Shimoda, Shigeitsu Y. Complication of infection and immunologic status after surgery for patients with esophageal cancer. J Sung oncol, 1991, 48: 21-27.

［2］Liang-Shun Wang, Hisao-Yo Lin, Chun-Ju Chang, et al. Effects of en bloc esophagectomy on nutritional and immune status in patients. with esophageal carcinoma: J Surg oncol, 1998, 67: 90-98.

［3］Thorhack RV, Chapman JB, Diehl AK, et al. Exogenous growth hormone: effects on the catabilic response to surgically reduced acute stress and on post-operative immune function. World J Surgery, 1993, 17 :530-532.

［4］Shiga C, Ohi R, Chiha T, et al. Assessment of nutritional status of post operative patients with biliary atresia. Tohoku J Exp Med, 1997, 181: 217-218.

收稿日期：1998-08-17

修稿日期：1999-11-01