低热量肠内营养支持对肝癌合并肝硬化患者术后康复及免疫功能的影响  

Effect of hypocaloric enteral nutrition on postoperative rehabilitation and immune function in hepatic carcinoma complicated with hepatic cirrhosis

作　　者：王剑彬 吴彩月 王丽斯[3] 吴恺明[4] 

机构地区：[1]广州医科大学附属乐从医院消化科,佛山528315 [2]广东省佛山市顺德区乐从社区卫生服务中心,佛山528315 [3]广州医科大学附属乐从医院检验科,佛山528315 [4]中山大学附属第一医院胃肠外科中心,广州510080

出　　处：《中国肿瘤临床与康复》2018年第1期51-54,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨低热量肠内营养(HEN)支持对肝癌合并肝硬化患者术后康复及免疫功能的影响。方法选取2015年1月至2017年1月间广州医科大学附属乐从医院收治的80例行肝癌切除术的原发性肝癌合并肝硬化患者,采用随机数表法分为HEN组和低热量肠外营养(HPN)组,每组40例。HEN组患者给予肠内营养制剂输注治疗,HPN组患者给予静脉营养输注治疗,比较两组患者治疗前后外周血中T细胞亚群(CD3+、CD4+、CD8+和CD4+/CD8+)水平、临床功能指标(住院天数、肠道功能恢复时间、出入院体重差及营养支持费用)及治疗过程中腹泻和导管感染等不良反应发生情况。结果 HEN组患者住院天数、肠道功能恢复时间、出入院体重差及营养支持费用均明显小于HPN组患者,差异均有统计学意义(均P<0.05)。治疗后,两组患者CD3+、CD4+及CD8+水平均明显高于治疗前,且HEN组水平均高于HPN组,差异均有统计学意义(均P<0.05);治疗后,两组患者CD4+/CD8+水平比较,差异无统计学意义(P>0.05)。HEN组不良反应发生率为7.5%,低于HPN组的10.0%,但差异无统计学意义(P>0.05)。结论 HEN支持能够提高肝癌合并肝硬化患者术后免疫功能,安全性较好,有利于术后康复,值得临床推广。Objective To investigate the effect of hypocaloric enteral nutrition（ HEN） on postoperative rehabilitation and immune function in hepatic cancer patients complicated with hepatic cirrhosis.Methods A total of 80 primary hepatic cancer patients complicated with hepatic cirrhosis who underwent hepatectomy at other hospitals and were currently treated at Foshan Shunde District Lecong Hospital from January 2015 to January 2017 were enrolled in this study. The subjects were divided into the HEN group and the hypocaloric parenteral nutrition（ HPN） group with 40 patients in each group according to the random table method. The HEN group was given enteral nutrition infusion therapy while the HPN group was given intravenous nutrition infusion therapy. The T lymphocyte subsets including CD3＋,CD4＋,CD8＋and CD4＋/CD8＋levels in the peripheral blood and clinical function indexes including length of hospitalization stay,changes in weight between admission and discharge and the costs of nutrition support were compared between the two groups before and after treatment. Results The length of hospitalization stay,changes in weight between admission and discharge and the costs of nutrition support was significantly lower in the HEN group in the HPN group（ all P〈0. 05）. The CD3＋,CD4＋and CD8＋levels were significantly higher in the two groups after treatment than before treatment with HEN group higher than HPN group（ all P〈0. 05）. There was no significant difference in CD4＋/CD8＋levels（ P〉0. 05）. The incidence of adverse reactions was 7. 5% for HEN group which was lower than 10. 0% of HPN group（ P〉0. 05）. Conclusion HEN support can improve the postoperative immune function,which has good safety and may promote postoperative recovery. It is worthy of clinical application.

关 键 词：低热量肠内营养 低热量肠外营养 肝肿瘤 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤]