早期谷氨酰胺强化联合百普力肠内营养支持对老年胃癌患者术后营养、免疫功能及肠黏膜屏障功能的影响  

Effects of early glutamine-enhanced enteral nutrition in combination with peptison on postoperative nutritional status, immune function and function of intestinal mucosal barrier in elderly patients with gastric cancer

作　　者：张海鸣[1] 潘瑞蓉[2] 周科军[1] 

机构地区：[1]江苏大学附属医院普外二科,江苏镇江212001 [2]江苏大学附属医院营养科,江苏镇江212001

出　　处：《中国现代医学杂志》2015年第21期107-110,共4页China Journal of Modern Medicine

摘　　要：目的探讨早期谷氨酰胺强化联合百普力肠内营养支持对老年胃癌患者术后营养、免疫功能及肠黏膜屏障功能的影响。方法该院110例行手术治疗的老年胃癌患者随机分为对照组和观察组,每组各55例。对照组于术后给予百普力早期肠内营养;观察组在对照组的基础上联合谷氨酰胺强化。比较两组患者营养前后营养状况、免疫功能、肠黏膜屏障功能及感染发生情况。结果与对照组相比,观察组营养后血清总蛋白及白蛋白水平显著升高,CD3+、CD4+水平显著升高,而CD8+水平显著下降,反映肠黏膜屏障功能的降钙素原、D-乳酸水平显著下降,差异均有统计学意义(P均<0.05)。术后观察组的感染发生率为10.9%,明显低于对照组29.1%的感染发生率,差异有统计学意义(P<0.05)。结论早期谷氨酰胺强化联合百普力肠内营养支持治疗能够改善老年胃癌术后患者营养状况,提高机体免疫功能及肠黏膜屏障功能,并降低感染发生率,临床上值得进一步研究。【Objective】To investigate the effects of early glutamine-enhanced enteral nutrition in combination with peptison on the postoperative nutritional status, immune function and function of intestinal mucosal barrier of elderly patients with gastric cancer. 【Methods】Totally 110 elderly postoperative patients with gastric cancer were randomly divided into 2 groups with equal number. The control group was given conventional early enteral nutrition with peptison after operation. Besides that, the observation group was given early glutamine-enhanced enteral nutrition. Then the nutritional status, immune function, function of intestinal mucosal barrier and incidence of infection were compared between both groups.【Results】In comparison with the control group, the observation group had statistically higher levels of serum total protein and albumin after nutritional therapy（both P 0.05）. As to immune function, the level of CD3＋and CD4＋was significantly higher and the level of CD8＋was statistically lower than that in the control group after nutrition（all P 0.05）. Procalcitonin and D-lactate in the observation group which reflected intestinal mucosal barrier function were statistically lower than those in the control group（both P 0.05）. After operation, the incidence of infection in the observation group was 10.9%, which was statistically lower than 29.1% in the control group（P 0.05）.【Conclusions】Early glutamine-enhanced enteral nutrition in combination with peptison for elderly postoperative patients with gastric cancer is effective, which can improve nutritional status, enhance immune function and intestinal mucosal barrier function, and reduce incidence of infection.

关 键 词：谷氨酰胺 百普力 早期肠内营养 免疫功能 肠黏膜屏障功能 

分 类 号：R473.73[医药卫生—护理学]