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

发布时间：2018-06-06 12:00

本文选题：胃癌 + 营养风险　；参考：《四川大学学报(医学版)》2017年03期

【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7d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(P0.05)。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(P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the effect of early enteral immune nutrition on postoperative nutritional status and immune function in patients with nutritional risk of gastric cancer. Methods NRS 2002 was used to screen the nutritional risk of newly admitted gastric cancer patients in West China Hospital of Sichuan University from February to December 2014. Patients with a score of 3 ~ 5 were randomly divided into trial group (30 cases of early postoperative enteral nutrition containing glutamine) and control group (30 cases of common enteral nutrition). The two groups were given 7 days nutritional support after operation. The peripheral venous blood was collected on an empty stomach 1 day before operation and 3 days after operation in both groups. The levels of CD3 ~ + CD4 ~ + CD8 ~ and CD4 ~ / CD8 ~ and nutritional status (plasma transferrin, prealbumin, albumin) were measured. At the same time, the first time of anal exhaust after operation, pulmonary infection, inflammatory intestinal obstruction and postoperative hospitalization time were recorded. Results the levels of CD4 ~ / CD8 ~, transferrin, plasma prealbumin and albumin in the trial group were significantly higher than those in the control group on the 3rd day and 7th day after operation, and the difference was statistically significant (P 0.05). Compared with the control group, the first time of anus exhaust in the experimental group was earlier than that in the control group [63.5 卤7.3 h vs.(72.8 卤8.6 h], and the difference was statistically significant (P 0.05). However, there was no significant difference in pulmonary infection, anastomotic fistula, severe abdominal distension and inflammatory intestinal obstruction between the two groups (P 0.05). Conclusion early enteral immune nutrition can promote the recovery of postoperative immune function and the rise of serum prealbumin and albumin levels in patients with gastric cancer associated with nutritional risk, and promote the recovery of postoperative intestinal function and postoperative recovery.
【作者单位】：四川大学华西医院胃肠外科;成都三六三医院胃肠外科;
【基金】：四川省科技厅科技支撑计划项目(No.2013FZ0091)资助
【分类号】：R735.2

【相似文献】