个体化肠内外营养治疗对食管癌患者术后康复的影响  

Influence of Individualized Parenteral and Enteral Nutrition Therapy on Rehabilitation of Patients With Esophageal Cancer After Operation

作　　者：陈星[1] 成争艳 张树巍[1] 王凯[1] 孙明伟[1] 

机构地区：[1]四川省医学科学院.四川省人民医院城东病区创伤外科,四川省成都市610101 [2]四川省医学科学院.四川省人民医院城东病区病理科,四川省成都市610101

出　　处：《中国全科医学》2015年第23期2837-2840,共4页Chinese General Practice

基　　金：四川省卫生厅2013年科研项目(130142)

摘　　要：目的探讨个体化肠内外营养治疗对食管癌患者术后免疫功能、营养状况以及炎性反应的影响。方法选取2010年1月—2014年9月在四川省人民医院接受手术治疗的食管癌患者90例,采用随机数字表法将其分为对照组和观察组,各45例。对照组患者术后第1天接受单纯肠内营养治疗;观察组患者术后第1天接受个体化肠内外营养治疗,能量供给肠内∶肠外=6∶4。观察两组患者术后首次排气时间和住院天数;术前、术后10 d体液免疫指标:Ig A、Ig M、Ig G;细胞免疫指标:CD+3T细胞、CD+4T细胞与CD+4/CD+8;营养指标:淋巴细胞、前清蛋白以及清蛋白;炎性反应:前列腺素E2(PGE2)和超敏C反应蛋白(hs-CRP)。结果观察组首次排气时间和住院天数均短于对照组(P<0.01)。手术前,两组患者Ig A、Ig M、Ig G、CD+3T、CD+4T、CD+4/CD+8、淋巴细胞、前清蛋白、清蛋白、PGE2和hs-CRP比较,差异均无统计学意义(P>0.05);术后10 d,观察组Ig A、Ig M、Ig G、CD+3T、CD+4T、CD+4/CD+8、淋巴细胞、前清蛋白均高于对照组(P<0.01),PGE2和hs-CRP均低于对照组(P<0.01)。结论个体化肠内外营养治疗对食管癌患者术后的康复具有显著效果,能够改善患者的营养状况,提高免疫功能,减轻炎性反应。Objective To investigate the effect of individualized parenteral and enteral nutrition therapy intervention on the immune function , nutritional status and inflammation responses in patients with esophageal cancer after operation . Methods We enrolled 90 patients with esophageal cancer who received operational treatment in Sichuan Provincial People ′s Hospital from January 2010 to September 2014.Using random number table method , the subjects were divided into two groups：control group （n=45） and observation group （n=45）.The control group was administrated with only enteral nutrition therapy on the first day after operation , and the observational group was administrated with both parenteral and enteral nutrition therapy on the first after operation with a parenteral/enteral ratio of 6∶4.The time until first fart after operation , the length of hospital stay , the immunity indicators （ IgA, IgM, IgG） 10 days before and after operation , the immunity indicators of cells , CD3＋T cell, CD4＋T cell, CD4＋/CD8＋, nutritional indicators （lymphocyte, prealbumin, albumin）, inflammation responses （PGE2, hs -CRP） .Results The observation group was shorter （ P〈0.01 ） than the control group in the time until the first fart after operation and length of hospital stay .The two groups were not significantly different （ P〉0.05） in IgA, IgM, IgG, CD3＋T, CD4＋T, CD4＋/CD8＋, lymphocyte, prealbumin, albumin, PGE2 and hs -CRP.The observational group was higher （ P 〈0.01） in IgA, IgM, IgG, CD3＋T, CD4＋T, CD4＋/CD8＋, lymphocyte and prealbumin and was lower in PGE 2 and hs-CRP than the control group . Conclusion Individualized parenteral and enteral nutrition therapy has significant efficacy in the rehabilitation of patients with esophageal cancer after operation .The therapy can improve nutritional status , improve immune function and reduce inflammation .

关 键 词：食管肿瘤 胃肠外营养 营养疗法 免疫 营养状况 炎症 

分 类 号：R735.1[医药卫生—肿瘤]