术前营养不良对结直肠癌患者术后感染及免疫功能的影响

发布时间：2018-06-24 20:31

本文选题：结直肠癌手术 + 术前营养不良　；参考：《中华医院感染学杂志》2017年24期

【摘要】：目的分析术前营养不良对结直肠癌患者术后感染及免疫功能的影响,为结直肠癌手术患者术前营养状况评估及营养支持治疗提供参考。方法选择2014年2月-2015年2月医院收治的结直肠癌患者119例作为研究对象,所有患者均择期行结直肠癌根治术,术前2d对患者行营养风险调查,根据调查结果将患者分为营养不良组64例和营养状况正常组55例;比较两组患者术前、术后1周T淋巴细胞(CD3+、CD_4~+、CD_8~+、CD_4~+/CD_8~+)、炎症因子[C-反应蛋白(CRP)、降钙素原(PCT)]水平和术后1个月内感染率。结果营养不良组患者术前T淋巴细胞(CD3+、CD_4~+、CD_4~+/CD_8~+)比例低于营养正常组,其中CD_8~+比例高于营养正常组,两组比较有统计学意义(P0.05);两组患者术前CRP、PCT比较无统计学意义;术后1周两组T淋巴细胞(CD3+、CD_4~+、CD_4~+/CD_8~+)比例均较术前下降,CD_8~+较术前增加(P0.05);术后两组患者CRP、PCT均高于术前,且营养不良组高于营养正常组(P0.05);术后1个月内营养不良组患者发生医院感染9例(14.06%),营养正常组发生3例(5.45%),营养不良组患者术后感染率高于营养正常组(P0.05)。结论术前营养不良可降低结直肠癌手术患者的免疫功能,增加术后感染的风险,临床应重视结直肠癌患者术前营养不良问题,尽可能在营养状况得到改善的前提下实施手术,以期降低术后感染率的发生,提高患者预后。
[Abstract]:Objective to analyze the effect of preoperative malnutrition on postoperative infection and immune function in patients with colorectal cancer, and to provide reference for preoperative nutritional evaluation and nutritional support therapy. Methods 119 patients with colorectal cancer admitted in our hospital from February 2014 to February 2015 were enrolled in the study. All patients underwent radical resection of colorectal cancer. The nutritional risk was investigated 2 days before operation. The patients were divided into malnutrition group (n = 64) and normal nutrition group (n = 55) according to the results of the investigation. One week after operation, the levels of T lymphocytes (CD3 + CD4 ~ + CD4 ~ +), inflammatory factor [C-reactive protein (CRP), procalcitonin (PCT)] and infection rate within 1 month after operation were compared. Results the ratio of preoperative T lymphocytes (CD3 / CD4 / CDS / CD8 ~) in dystrophy group was lower than that in normal group, and the ratio of CD8 ~ + was higher than that of normal nutrition group (P0.05), but there was no significant difference between two groups in preoperative CRPPnPCT. At one week after operation, the ratio of T lymphocytes (CD3 + CD4 ~ + CD4 ~ + / CD8 ~ +) in two groups was significantly higher than that before operation (P0.05), and the ratio of CRP / PCT in two groups was higher than that before operation (P < 0.05), and the ratio of CD8 ~ / CD8 ~ + in two groups was higher than that before operation. The nosocomial infection occurred in 9 cases (14.06%) in the malnutrition group and 3 cases (5.45%) in the malnutrition group within one month after operation. The postoperative infection rate in the malnutrition group was higher than that in the normal group (P0.05). Conclusion preoperative malnutrition can reduce the immune function of patients with colorectal cancer and increase the risk of postoperative infection. Clinical attention should be paid to the problem of preoperative malnutrition in patients with colorectal cancer. In order to reduce the incidence of postoperative infection and improve the prognosis of patients.
【作者单位】：郑州大学附属郑州中心医院胃肠血管疝外科;
【分类号】：R735.3

【相似文献】