摘要
目的观察早期应用肠内营养制剂对胃癌患者术后营养状况和免疫功能的影响。方法选取2015年1月—2016年12月河北北方学院附属第一医院普外科住院的胃癌患者85例作为研究对象,观察组45例于术后早期给予肠内营养,对照组40例患者术后给予肠外营养。观察术前、术后第1、7天的2组患者营养状况(血清PAB、TRF、Alb),IgA、IgG、IgM、CD3^+、CD4^+、CD4^+/CD8^+水平,术后恢复情况(首次排气、排便、下床、平均住院时间)。结果与术前比较,2组术后1d血清PAB、TRF、Alb水平均明显下降,但对照组下降程度大于观察组;术后7 d观察组各项营养指标明显上升,但对照组仍低于观察组(P<0.05);2组术后1d患者血清IgA、IgG、IgM、CD3^+、CD4^+、CD4^+/CD8^+水平较术前均明显下降,但对照组下降程度大于观察组,术后7 d观察组各项免疫指标明显上升接近于术前,但对照组仍明显低于术前,且低于观察组(P<0.05)。观察组下床时间(20.3±3.1)h、首次排气时间(52.5±10.1)h、排便时间(64.1±9.0)h和平均住院时间(12.7±1.8)d,均明显早/短于对照组(31.3±2.0)h、(69.2±11.7)h、(82.5±9.1)h、(16.5±2.6)d,差异具有统计学意义(P<0.05)。结论胃癌患者早期给予积极的肠内营养支持能明显改善营养状况,提高机体免疫力,促进快速康复。
Objective To discuss the impact of early internal nutrition support on effect of postoperative nutrition index and immune function of patients with gastric cancer. Methods Eighty-five patients with gastric cancer in the Dept. of General Surgery from January 2015 to December 2016 in the First Affiliated Hospital of Hebei North University were selected, 35 patients received internal nutrition support （ Observation group） and 50 patients received non-internal nutrition support （Control group） before surgery and early period post-operation. The nutrition index （PAB, TRF, Alb） and immune function （ IgA, IgG, IgM, CD3^＋ , CD4^＋ , CD4^ ＋/CD8^ ＋ ） before surgery and early period postoperative 1 and 7 day were detected and compared. The postoperative recoveries （ the average time of hospital, first exhaust time, getting up of bed time, first defecation time） were recorded. Results The serum PAB, TRF, and Alb of postoperative 1 day were significantly lower than those before surgery, but the control group decreased more significantly （ P 〈 0.05 ）. The all nutrition index of postoperative 7 day in the observation group were higher than those before surgery, but those in the control group were still lower, （ t = 8. 528, P=0.000, t=8.163, P=0.000, t=7. 158, P=0. 000）. The serum IgA, IgG, IgM, CD3^＋, CD4^＋, and CD4^＋/CD8^＋ level of postoperative 1 day were significantly lower than those before surgery, but the control group decreased more significantly （P 〈 0.05 ）. The all immune function of postoperative 7 day in the observation group were high than those before surgery, but those in the control group were lower than those before surgery （ t = 1. 762, P = 0. 040, t = 2. 198, P = 0. 020, t = 2. 096, P = 0. 022, t = 4.545, P = 0. 000, t = 3. 978, P = 0. 000, t = 5. 655, P = 0. 000）. The first exhaust time was （52.5±10. 1 ） h, the first defecation time was （64.1 ± 9.0） h, the getting up of bed time was （20.3 ± 3.1 ） h and average time of hospital was （12.7 ±1.8）d in the observation group, which were significantly earlier than （69.2 ±11.7）h, （82.5 ±9.1）h,（31.3±2.0） h and （ 16.5 ± 2.6） d in control group, and there was statistical differences （P 〈 0.05 ）. Conclusion Early nutrition support of patients with gastric cancer can significantly improve the nutritional status, immune function, reduce postoperative complications, and accelerate rehabilitation.
出处
《疑难病杂志》
CAS
2018年第1期63-66,共4页
Chinese Journal of Difficult and Complicated Cases
基金
河北省政府资助临床医学优秀人才培养研究项目(3101-03-02)
张家口市科技局指导性计划(1621097D)
关键词
早期肠内营养支持
胃癌
营养状况
免疫功能
影响
Early internal nutrition support
Gastric cancer
Nutrition index
Immune function
Impact
