生长激素联合免疫肠内营养在大肠癌患者围手术期的应用  

Application of enteral nutrition combined with recombined human growth hormone in colon cancer patients during perioperation

作　　者：马骏[1] 马春笋[1] 寸英丽[1] 代佑果[1] 

机构地区：[1]云南省肿瘤医院腹部肿瘤外科,昆明650118

出　　处：《临床外科杂志》2010年第6期389-391,共3页Journal of Clinical Surgery

基　　金：云南省教育厅科研基金资助项目（062127c）

摘　　要：目的探讨大肠癌患者术后应用重组人生长激素（rhGH）联合免疫肠内营养Sup—portan的安全性、有效性。方法将大肠癌患者72例随机、单盲分为治疗组（肠内营养＋rhGH）21例，肠内营养对照组26例，肠外营养对照组25例。比较行大肠癌根治手术前后三组患者的营养、免疫指标。观察术后并发症发生率及随访3年结果。结果术后第14天治疗组PALB值已经恢复至术前水平之上，肠内营养组较肠外营养组有明显恢复但仍未达到术前水平，而肠外营养组仍处于术前水平以下。治疗组术后第8天、14天CD4^＋／CD8^＋值较PN组明显上升。治疗组并发症发生率明显低于对照组（P〈0．05）。结论大肠癌根治术后联合使用GH与免疫型肠内营养制剂改善了患者术后的营养状况和免疫功能，减少了术后并发症，对其生存率和肿瘤复发率没有明显的影响。对能手术根治的大肠癌术后短期小剂量使用rhGH联合Supportan是安全有效的，可作为术后较为合理的营养支持方法。Objective To investigate the security and effectiveness of enteral nutrition （EN） together with recombined human growth hormone （rhGH） in the treatment of colon cancer after the operation. Methods Seventy - two colon cancer patients were randomly divided into EN ＋ rhGH group （ n = 21 ）, EN group （ n = 26）, and （PN） （ n = 25 ） group. Pre - and post - operative nutritional status, immune function, postoperative complication rate and the results of three - year follow - up were examined. Results Fourteen days after the operation, （PALB） returned to the normal level in the EN ＋ rhGH group, nearly arrived at the normal in the EN group, still remained low in the PN group. The proportion of CD4 ^＋/CD8 ^＋ in the EN ＋ rhGH group was increased significantly as compared with that in the PN group 8 and 14 days after the operation. The postoperative complications were reduced significantly in the EN ＋ rh- GH group （P 〈 0.05）. Conclusion Administration of EN combined with rhGH improves the postoper- ative nutritional status and immune function of colon cancer patients, reduces the postoperative complications and exerts no effects on the survival and tumor recurrence rates.

关 键 词：人生长激素 肠内营养 大肠癌根治术 免疫 

分 类 号：R735[医药卫生—肿瘤]