胃癌术后患者免疫型肠内营养的输注方案  

Infusion methods of immune enteral nutrition for patients with gastric cancer after operation

作　　者：陆峰 周井荣 邱磊[1] 杨修伟 苗永昌[1] 王刚[1] Lu Feng;Zhou Jingrong;Qiu Lei;Yang Xiuwei;Miao Yongchang;Wang Gang(Department of General Surgery, the Second People’s Hospital of Lianyungang, Lianyungang 222006, China)

机构地区：[1]江苏省连云港市第二人民医院普外科,222006

出　　处：《中国实用医刊》2019年第15期12-15,共4页Chinese Journal of Practical Medicine

基　　金：连云港市卫计委资助项目(201516);连云港市科技局资助项目(SH619);连云港市第二人民医院中青年医学人才成长基金项目(TQ20H08).

摘　　要：目的探讨胃癌术后患者免疫型肠内营养的输注方案。方法选择连云港市第二人民医院2017年1月至2018年12月收治的97例胃癌患者为研究对象,采用随机数字表法分为观察组49例和对照组48例。观察组采用持续性免疫型肠内营养输注方案,对照组采用周期性免疫型肠内营养输注方案。比较两组肠内营养的输注情况、手术前后各项营养指标及免疫指标的变化情况。结果对照组出现免疫型肠内营养不耐受情况3例,观察组患者耐受情况好(P<0.05)。观察组达全肠内营养的时间及拔管时间分别为(3.3±1.3)、(5.5±1.9)d,均短于对照组的(4.6±1.2)、(7.4±2.6)d(t=4.920、4.009,P均<0.05)。术前1 d及术后第1、7天,两组患者总蛋白、白蛋白、前白蛋白及转铁蛋白比较差异未见统计学意义(P>0.05)。术前1 d和术后第1天,两组各项免疫指标比较差异未见统计学意义(P>0.05);术后第7天,观察组IgA、CD4/CD8分别为(2.9±0.5)g/L、2.2±0.5,均高于对照组的(2.6±0.7)g/L、2.0±0.6(t=2.706、2.101,P均<0.05);两组患者其余指标比较差异未见统计学意义(P>0.05)。结论与周期性输注相比,持续性输注免疫型肠内营养能够减少营养不耐受情况,缩短胃癌术后患者过渡到全肠内营养的时间及拔管时间,对胃癌患者的各营养指标影响较小,且能够提高机体的免疫功能,值得临床推广应用。Objective To investigate the infusion methods of immune enteral nutrition for patients with gastric cancer after operation. Methods Ninety-seven patients with gastric cancer admitted to the Second People’s Hospital of Lianyungang from January 2017 to December 2018 were selected as the study subjects. According to random number table method, patients were randomly divided into observation group (49 cases) and control group (48 cases). Patients in observation group were given continuous immune enteral nutrition, while patients in control group were given periodic immune enteral nutrition. The changes of enteral nutrition infusion, nutritional and immune indexes before and after operation were compared between the two groups. Results Three patients showed immune enteral nutrition intolerance in control group, and the patients in observation group were tolerant to nutrition supply (P<0.05). The time of starting total enteral nutrition and extubation in observation group were (3.3±1.3)d and (5.5±1.9)d, respectively, shorter than those in control group, which were (4.6±1.2)d and (7.4±2.6)d, respectively, and the difference was statistically signficant (t=4.920, 4.009, all P<0.05). There was no significant difference in levels of total protein, albumin, prealbumin and transferrin between the two groups on the 1st day before operation and the 1st and 7th day after operation (P>0.05). IgA and CD4/CD8 in observation group on 7th day were (2.9±0.5)g/L and 2.2±0.5, respectively, which were significantly higher than those in control group, which were (2.6±0.7)g/L and 2.0±0.6, respectively, and the difference was statistically significant (t=2.706, 2.101;all P<0.05). There was no significant difference in the other indicators between the two groups (P>0.05). Conclusions Compared with periodic infusion, continuous infusion of immune enteral nutrition can reduce the nutrition intolerance, shorten the time of transition to total enteral nutrition and extubation after gastric cancer surgery, which has less influence on t

关 键 词：免疫型肠内营养 胃癌 术后 输注方案 

分 类 号：R735.2[医药卫生—肿瘤]