肠内免疫微生态营养支持对肝切除患者肝功能的影响  

Effect of enteral ecoimmunonutrition supports on liver function in patients with hepatectomy

作　　者：郑永 康利民 杨文雄 周雅豪 王阿勇 施红宁 张景山 赵应宏 吴洁 

机构地区：[1]云南省普洱市人民医院肝胆外科,665000

出　　处：《中国实用医刊》2011年第11期13-15,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨肠内营养（EN）和肠内免疫微生态营养（EIN）对肝切除术后患者肝脏功能的影响。方法将82例肝切除患者随机分为两组，手术后分别接受肠内营养和肠内免疫微生态营养1周，观察两种营养方式对患者内毒素、细胞因子及肝功能的影响。结果术前EIN组内毒素、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）及肝功能与EN组比较差异无统计学意义（P〉0．05）。营养支持1周后，EIN组内毒素、TNF-α和IL-6分别为（1．88±0．17）pg／ml、（260±28）pg／ml、（158±8）pg／ml，上述指标均较EN组明显下降（P〈0．01或P〈0．05）。EIN组1周后肝功能各项指标与EN组比较差异有统计学意义（P〈0．01或P〈0．05）。结论肠内免疫微生态营养，可以补充肠道正常菌群，减少细菌易位，减少内毒素血症及炎症因子的发生，从而减轻肝切除术后的肝损害。Objective To explore the effects of enteral nutrition（EN） and ecoimmunonutrition（EIN） support routes on liver function after hepatec, tomy. Methods In this study,82 patients were randomized into two groups to respectively receive enteral nutrition or eeoimmunonutrition support beginning the first day post - operation for a week. The level of plasma endotoxin, cytokines and hepatic function were recorded. Results The serum level of plasma endotoxin, TNF-α and IL- 6 in EIN group were no differenee eomparied with EN group at preoperative phase. Seven days after nutrition support, the serum level of plasma endotoxin, TNF -α and IL - 6 in EIN group were （ 1. 88 ± 0.17 ） pg/ml, （260 - 28 ） pg/ml, （ 158 ± 8 ） pg/ml, respeetively, which were all signifieantly lower than those of EN group （P 〈 0.01 or P 〈0.05）. The hepatic function in EIN group were significantly different 1 week EIN n statistics than the EN group after one （P 〈 0. 01 or P 〈 0.05 ）. Conclusions can compensate for normal flora in the gut, reduce bacterial translocation, modulate immunologic function, attenuate the serum level of plasma endotoxin and cytokines, alleviate hepatic injury after hepatectomy.

关 键 词：肝切除 肝功能 肠内营养 肠道免疫微生态营养 

分 类 号：R735.7[医药卫生—肿瘤]