免疫营养对急腹症患者加速康复的影响  

Effect of immune nutrition on enhanced recovery after surgery of patients with acute abdomen

作　　者：张雪娟 刘海燕[1] Zhang Xuejuan;Liu Haiyan(The Emergency Center of the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]郑州大学第一附属医院急救中心

出　　处：《河南外科学杂志》2019年第5期13-18,共6页Henan Journal of Surgery

摘　　要：目的探讨免疫营养对急腹症患者加速康复的影响。方法收集2017-03-2018-03间因急腹症于郑州大学第一附属医院急诊手术的410例患者。随机分为肠内免疫营养(EIN)组和肠内标准营养(EN)组。2组均于术后24 h按25 Kcal/(kg·d)给予相应营养制剂。EIN组给予富含谷氨酰胺、精氨酸、ω-3脂肪酸的免疫增强型肠内营养制剂;EN组给予普通肠内营养制剂。于术前,术后第1、5、7天分别检测患者血清中ALB、PA、CD4^+、CD4^+/CD8^+、IgA、IgG、IgM水平。结果2组患者术前一般情况及实验室指标无明显差异(P>0.05)。术后第1天ALB、PA、、CD4^+、CD4^+/CD8^+、IgA、IgG、IgM水平均较术前下降,但无统计学差异(P>0.05)。术后第5、7天,2组患者上述指标较前上升,EIN组较EN组上升更明显,差异有统计学意义(P<0.05)。结论在应用加速康复外科理念救治急腹症患者的过程中联合免疫营养治疗,能更有效减轻患者应激反应,改善患者营养状况,提高患者免疫功能,加速患者康复。Objective To explore the effects of immunonutrition on the nutritional status and immune function of patients with acute abdomen treated with the enhanced recovery after surgery program.Methods A total of 486 patients who underwent Emergency Surgery from the First Affiliated Hospital of Zhengzhou University from March 2017 to March 2018 were collected.They were randomLy divided into the enteral immunonutrition(EIN)group and the enteral nutrition(EN)group.The two groups were given the corresponding nutritional preparations at 25 Kcal/(Kg·d)24 hours after operation.The serum levels of ALB,PA,CD4^+,CD4^+/CD8^+,IgA,IgG and IgM were measured in preoperative and postoperative.Results There were no significant differences between the two groups in preoperative general conditions and laboratory parameters(P>0.05).The levels of ALB,PA,CD4^+,CD4^+/CD8^+,IgA,IgG and IgM decreased on the first day after surgery,and there was no statistical difference between the two groups(P>0.05).On the 5 th and 7 th day after operation,the above indexes were increased in the two groups,and the EIN group was more obvious t(P<0.05).Conclusion The combination of immunonutrition and enhanced recovery after surgery program for patients with acute abdomen can more effectively alleviate the patient’s stress response,improve the nutritional status and the immune function of patients,and accelerate the recovery of patients.

关 键 词：加速康复外科 免疫营养 急腹症 免疫功能 

分 类 号：R656.1[医药卫生—急诊医学]