术前使用免疫增强型肠内营养对结直肠癌病人术后营养和并发症影响的前瞻性研究  

Effects of preoperative immune enhanced enteral nutrition on postoperative nutritional status and complications in colorectal cancer patients

作　　者：李卡[1] 郭海燕[2] 张静[3] 胡艳杰[3] 黄明君[1] 

机构地区：[1]四川大学华西医院胃肠外科中心,四川成都610041 [2]四川大学华西医院临床医学院,四川成都610041 [3]四川大学华西医院护理学院,四川成都610041

出　　处：《肠外与肠内营养》2014年第6期329-332,共4页Parenteral & Enteral Nutrition

基　　金：四川省科技厅科技支撑计划项目基金(2012SZ0039)

摘　　要：目的:观察术前使用免疫增强型肠内营养(EN)制剂对结直肠癌病人术后营养和并发症发生情况的影响,以探讨术前辅助免疫增强型EN的有效性和安全性。方法:前瞻性纳入我院胃肠外科结直肠癌专业组收治的123例符合条件的病人,随机分为两组。试验组58例病人,在术前常规治疗的基础上口服免疫增强型EN制剂;对照组65例,术前行常规治疗,使用普通口服EN制剂。比较两组病人术后营养情况以及并发症发生情况的差异。结果:两组病人术前营养情况无统计学差异(P>0.05)。术后试验组病人血清清蛋白明显高于对照组,且差异有显著性统计学意义(P<0.05);术后NRS 2002营养风险评分亦明显低于对照组(P<0.05);术后总并发症的发生率明显少于对照组(P<0.05),其中切口出血、伤口感染、肺部感染的发生率明显低于对照组,且差异有显著性统计学意义(P<0.05)。结论:术前使用免疫增强型EN制剂可有效地提高结直肠癌病人术后的营养状况,降低术后并发症的发生率。Objective ： The impact of immune-enhancing enteral nutrition on colorectal cancer patients＇postoperative nutritional status and complications was observed. Methods： 123 patients were enrolled. The patients were randomly allocated into two groups. In the controlled group,65 patients received conventional therapy and common oral enteral nutrition before operation. In the treatment group ,58 patients received immune-enhancing enteral nutrition before operation. Postoperative nutritional status and occurrence of complications were compared between two groups. Results：The baseline conditions were not statistically significant between two groups （P 〉 0.05 ）. In the postoperative nutritional index, albumin was higher in the treatment group （P 〈 0.05 ）. The treatment group had a lower score than the controlled group on Nutrition Risk Screening 2002 （ P 〈 0.05 ）. There was statistically significant difference in overall incidence of postoperative complications between the two groups （P 〈 0.05 ）. The incidences of wound bleeding, wound infection and pulmonary infection in treatment group was lower than that in con- trolled group （ P 〈 0.05 ）. Intra-abdominal infection and anastomotic leakage didn＇t occur in the two groups. Conclusion：Preoperative immune-enhancing enteral nutrition can effectively improve the nutritional status and reduce the of postoperative complications in colorectal patients.

关 键 词：免疫营养 结直肠癌 并发症 

分 类 号：R735.34[医药卫生—肿瘤]