欢迎来到《四川大学学报(医学版)》
彭昌兵, 李文忠, 徐 锐, 等.早期肠内免疫营养对胃癌伴营养风险患者术后营养状态和免疫功能的影响.四川大学学报(医学版),2017,48(3):427-430
早期肠内免疫营养对胃癌伴营养风险患者术后营养状态和免疫功能的影响
Effects of Early Enteral Immunonutrition on Postoperative Immune Function and Rehabilitation of
  
中文关键词:  胃癌 营养风险 早期肠内营养 免疫营养
英文关键词:Gastric cancer Nutritional risk Early enteral nutrition Immunonutrition
基金项目:
摘要点击次数: 2221
全文下载次数: 0
中文摘要:
      目的探讨早期肠内免疫营养对胃癌伴营养风险患者术后营养状态和免疫功能的影响。方法将2014年2~12月期间四川大学华西医院胃肠外科新入院胃癌患者运用NRS 2002进行营养风险筛查,将评分在3~5分的患者随机分为试验组(术后早期给予含谷氨酰胺的肠内营养,30例)和对照组(术后早期给予普通肠内营养,30例),两组术后给予7 d营养支持。两组患者分别于术前1天和术后第3、7天空腹采集外周静脉血,用于检测细胞免疫指标(CD3+、CD4+、CD8+和CD4+/CD8+比值)、营养状态指标(血浆转铁蛋白、前白蛋白、白蛋白水平)。同时观察记录术后首次肛门排气时间、术后住院期间肺部感染、炎性肠梗阻、术后住院时间等。结果术后第3天和术后第7天试验组患者CD4+/CD8+、转铁蛋白、血浆前白蛋白、白蛋白水平均高于对照组,差异有统计学意义( P<0.05)。与对照组相比,试验组患者术后肛门首次排气时间提前〔(63.5±7.3) h vs. (72.8±8.6) h〕,差异有统计学意义(P< 0.05)。但肺部感染、吻合口瘘、严重腹胀、炎性肠梗阻等方面,组间差异无统计学意义(P>0.05)。结论早期肠内免疫营养促进了胃癌伴营养风险患者术后免疫功能的恢复和血清前白蛋白、白蛋白水平的回升,促进了患者术后肠道功能的恢复和术后的康复。
英文摘要:
      Objective To investigate the effects of early enteral immunonutrition on postoperative immune function and rehabilitation of gastric cancer patients with nutritional risk. Methods New hospitalized patients with gastric cancer were evaluated the nutrient status based on NRS 2002. The patients who scored between 3 to 5 points were randomized into two groups(30 cases for each group), and those in experimental group were given 7-d early postoperative enteral immune nutrition,those in control group were given normal nutrition. The immune indexes (CD3+, CD4+, CD8+ and CD4+/CD8+) and nutritional indexes(transferrin, pre-albumin, albumin) were measured before operation and at the 3rd and 7th day postoperatively. In addition, the first flatus time, gastrointestinal adverse reactions and complications, length of hospital stays were compared between the two groups. Results The level of CD4+/CD8+ and transferrin, pre-albumin, albumin in experimental group were significantly higher than those in control group at the third and seventh day postoperatively (P<0.05).Compared with the control group, the experimental group had shorter first flatus time after surgery, which were (63.5±7.3) h vs. (72.8±8.6 ) h respectively (P<0.05).There were no statistically difference on pneumonia, anastomosis leakage, severe abdominal distension, inflammatory bowel obstruction and total postoperative hospitalization time between the two groups (P>0.05).Conclusion Early enteral immunonutrition can effectively promote the recovery of nutritional status and immune function in gastric cancer patients with nutrition risk.
查看全文  查看/发表评论  下载PDF阅读器
关闭