免疫营养素对恶性梗阻性黄疸胆道支架植入术后感染发生率的影响  

Effect of Immune Nutrients on the Incidence of Infection after Biliary Stent Implantation in Patients with Malignant Biliary Obstruction

作　　者：刘承利[1] 张辉[1] 王成[1] 孔亚林[1] 赵刚[1] 肖梅[1] 何晓军[1] 

机构地区：[1]空军总医院肝胆外科,北京100142

出　　处：《现代生物医学进展》2017年第5期882-885,共4页Progress in Modern Biomedicine

基　　金：首都市民健康项目培育课题(Z131100006813010)

摘　　要：目的:探讨免疫营养素对恶性梗阻性黄疸患者胆道支架植入术后感染的发生情况及临床预后的影响。方法:选择2013年2月到2016年1月选择在我院诊治的恶性梗阻性黄疸患者156例,据入院顺序分为观察组与对照组各78例,两组均行PTCD^+胆道金属支架植入术,观察组入院当日开始给予免疫营养制剂(在普通低脂饮食基础上添加鱼油脂肪酸和复方谷氨酰胺肠溶胶囊)口服,对照组入院当日开始给予普通低脂饮食,两组均治疗5 d,观察两组预后情况。结果:两组术后15 d的CD4^+值都明显高于术后1 d(P<0.05),观察组术后15 d的CD4^+值也明显高于对照组(P<0.05),两组不同时间点的CD8^+值对比差异无统计学意义(P>0.05)。观察组与对照组术后15 d的血清IL-6和TNF-α值都明显低于术后1 d(P<0.05),观察组术后15 d的血清IL-6和TNF-α值也明显低于对照组(P<0.05)。观察组术后感染发生率为5.1%,明显低于对照组的20.5%(P<0.05)。结论:胆道支架植入术术前应用免疫营养素可改善恶性梗阻性黄疸患者的免疫功能,抑制炎症反应,从而减少感染的发生率,促进患者的康复。Objective： To investigate the effects of immune nutrients on the incidence of infection after biliary stent implantation in patients with biliary stent implantation. Methods： From February 2013 to January 2016, 156 malignant obstruction jaundice patients were selected in our hospital and randomly divided into the observation group and the control group with 78 patients in each group, both groups were given biliary stent implantation, the observation group was given immunonutrition formula including fish oil fatty acids and glutamine compound enteric coated capsules in the general diet, the control group was treated by general diet from the beginning after admission, both groups were treated for 5 days. Results： On the 15 th day after operation, the CD4^＋values of both groups were significantly higher than those on the 1st day after operation（P〈0.05）, and the CD4^＋value of observation group was significantly higher than that of the control group（P〈0.05）. No significant difference was found in the CD8^＋value between two groups at different time points（P〈0.05）.On the 15 th day after operation, the serum IL-6 and TNF-α levels in both groups were significantly lower than those on the 1st day after operation（P〈0.05）, and the serum IL-6 and TNF-α levels of observation group were significantly lower than those of the control group（P〈0.05）. The infection rate of observation group after operation was 5.1%, which was obviously lower than that of the control group of20.5%（P〈0.05）. Conclusion： Immune nutrition applied before biliary stent implantation could effectively improve the immune function,inhibit the release of inflammatory factors, decrease the infection and further promote the patient＇s recovery.

关 键 词：免疫营养素 胆道支架植入术 恶性梗阻性黄疸 感染 免疫 

分 类 号：R657.4[医药卫生—外科学] R735.8[医药卫生—临床医学]