肠内免疫微生态营养支持对肝癌肝切除术后病人肝损害的影响  

Effect of enteral ecoimmunonutrition supports on hepatic injury in patients with hepatectomy to liver cancers

作　　者：丁佑铭[1] 付海峰[1] 周文波[2] 

机构地区：[1]武汉大学人民医院肝胆腔镜外科,湖北武汉430060 [2]湖北医药学院附属东风医院肝胆外科,湖北十堰442000

出　　处：《肠外与肠内营养》2014年第4期214-216,221,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨肠外营养(PN)和肠内免疫微生态营养(EIN)对肝切除术后病人肝损害的影响。方法:将62例肝切除病人随机分为两组,手术后第1天起分别接受PN和EIN支持,共1周。观察两种营养方式对病人血清内毒素、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和肝功能的影响。结果:术前EIN组病人血清内毒素、TNF-α、IL-6和肝功能与PN组比无显著性差异(P>0.05)。营养支持1周后,EIN组病人血清内毒素、TNF-α和IL-6水平均较PN组明显下降(P<0.05)。EIN组1周后肝功能各项指标与PN组比差异亦有统计学意义(P<0.05)。结论:EIN可通过保护肠黏膜屏障功能,减轻肝缺血-再灌注损伤,从而减轻肝癌病人肝切除术后的肝损害。Objective：To explore the effects of parenteral nutrition （PN） and enteral ecoimmunonutrition （EIN） support routes on hepatic injury after hepatectomy.Methods：In this study,72 cases were randomly divided into parenteral nutrition group and enteral ecoimmunonutrition support group getting nutrition for one week from the first day after operation.The level of plasma endotoxin,TNF-α,IL-6 and hepatic function were recorded.Results：The serum level of plasma endotoxin,TNF-α and IL-6 in EIN group were no difference comparied with PN group at preoperative phase （P ＞ 0.05）.A week after nutrition support,the serum level of plasma endotoxin,TNF-e and IL-6 in EIN group were all significantly lower than those of PN group （P ＜ 0.05）.The hepatic function in EIN group was significantly different in statistics from the PN group after one week （P ＜ 0.05）.Conclusion：Enteral ecoimmunonutrition can alleviate hepatic ischemia-reperfusion injury （HIRI） by protecting the intestinal barrier function and thereby alleviate hepatic injury after hepatectomy to liver cancers.

关 键 词：肝切除 肝损害 肠外营养 肠内免疫微生态营养 

分 类 号：R459.3[医药卫生—治疗学] R735.7[医药卫生—临床医学]