早期免疫增强型肠内营养支持对老年结直肠癌患者术后免疫功能、营养状态及术后并发症的影响  

Effect of early immune-enhanced enteral nutrition support on postoperative immune function,nutritional status,and postoperative complications in elderly patients with colorectal cancer

作　　者：孙金珂 张孝宇 黄权[2] 岑凤珠 SUN Jin-ke;ZHANG Xiao-yu;HUANG Quan;CEN Feng-zhu(Graduate School,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,CHINA;Department of Gastrointestinal Surgery,Baise People's Hospital,Baise 533000,Guangxi,CHINA;Department of Nutrition,Baise People's Hospital,Baise 533000,Guangxi,CHINA)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]百色市人民医院胃肠外科,广西百色533000 [3]百色市人民医院营养科,广西百色533000

出　　处：《海南医学》2020年第6期685-688,共4页Hainan Medical Journal

基　　金：广西百色市科学研究与技术开发计划(编号:百科20192523)。

摘　　要：目的 探讨早期免疫增强型肠内营养支持对老年结直肠癌患者术后免疫功能、营养状态及术后并发症的影响.方法 选取百色市人民医院胃肠外科2018年9月至2019年9月期间行结直肠癌根治性切除术的老年患者60例为研究对象,按随机数表法分为早期免疫增强型肠内营养支持组(EIEN组)和早期常规型肠内营养支持组(EEN组),每组30例.比较两组患者术前1 d、术后1 d、术后7 d的免疫功能指标[T淋巴细胞亚群(CD3、CD4、CD8、CD4/CD8)、免疫球蛋白(IgA、IgM、IgG)]、营养指标[总蛋白(TP)、前清蛋白(PA)、清蛋白(ALB)、转铁蛋白(TF)]及术后并发症发生情况.结果 术前1 d,两组患者的免疫功能指标、营养指标比较差异均无统计学意义(P>0.05);术后1 d,两组患者的上述各项指标比较差异亦无统计学意义(P>0.05);术后7 d,EIEN组患者的免疫功能指标、营养指标明显优于EEN组,差异具有统计学意义(P<0.05);术后7 d,EIEN组患者术后感染性并发症发生率为16.67%,明显低于EEN组的46.67%,差异具有统计学意义(P<0.05),但非感染性并发症发生率两组比较差异无统计学意义(P>0.05).结论 与常规肠内营养支持相比,老年结直肠癌患者术后早期给予免疫增强型肠内营养支持对提高患者免疫功能和营养状态效果更佳,其可减少术后并发症并改善预后,值得临床上推广应用.Objective To investigate the effect of early immune-enhanced enteral nutrition support on postoperative immune function,nutritional status,and postoperative complications in elderly patients with colorectal cancer.Methods Sixty elderly patients who underwent radical resection of colorectal cancer for a period of time from Septem-ber 2018 to September 2019 in Baise People's Hospital were selected and divided into early immune-enhanced enteral nutrition support group(EIEN group,30 cases)and early routine enteral nutritional support group(EEN group,30 cases)according to random number table.The immune function indicators,including T lymphocyte subsets(CD3,CD4,CD8,CD4/CD8)and immunoglobulins(IgA,IgM,IgG)of the two groups on 1 day before surgery,1 day after surgery,and 7 days after surgery were compared,as well as nutrition indicators(total protein[TP],prealbumin[PA],albumin[ALB],transferrin[TF])and postoperative complications.Results On 1 d before surgery,there was no significant difference in the immune function indexes and nutritional indexes between the two groups(both P>0.05).On 1 d after surgery,there was no significant difference in the above indicators between the two groups(P>0.05).On 7 d after surgery,the immune function indexes and nutrition indexes of the EIEN group were significantly better than those of the EEN group,and the differences were statistically significant(P<0.05).On 7 d after surgery,the incidence of postoperative infectious complications in the EIEN group was 16.67%,significantly lower than 46.67%in the EEN group(P<0.05),but the incidence of non-infectious complications showed no statistically significant difference between the two groups(P>0.05).Conclusion Compared with conventional enteral nutrition support,early postoperative immune-enhanced enteral nutrition support for elderly colorectal cancer patients has a better effect on improving patients'immune function and nutritional status,which can reduce postoperative complications and improve prognosis,which is worth clinical Promotion appli

关 键 词：免疫增强型肠内营养 结直肠癌 免疫功能 营养状态 并发症 

分 类 号：R735[医药卫生—肿瘤]