序贯营养支持对结直肠癌患者术后抗肿瘤免疫应答及营养状况的影响  

The effect of sequential enteral nutrition support on nutritiond status and anti-tumor immune response after colorectal cancer surgery

作　　者：孙江华[1] 秦晓辉[1] 刘昱良 Sun Jianghua;Qin Xiaohui;Liu Yuliang(General Surgery Department,the First Hospital of Handan City,Hebei Handan 056001,China)

机构地区：[1]邯郸市第一医院普外科,河北邯郸056001

出　　处：《现代肿瘤医学》2020年第15期2693-2696,共4页Journal of Modern Oncology

基　　金：邯郸市科学技术与发展计划项目(编号:1323108137)。

摘　　要：目的:评估序贯营养支持对结直肠癌患者术后炎性反应、抗肿瘤免疫应答及营养状况的影响。方法:本研究为一项前瞻性、随机、对照研究。研究将从2017年6月1日至2018年5月31日在我院接受结直肠癌根治术的154例患者根据随机数字表1∶1随配为序贯营养支持组(实验组,n=77)和常规肠内营养支持组(对照组,n=77)。两组患者分别于术前清晨及术后5天测定营养相关参数(BMI,PA,ALB,Hb),炎性反应参数(WBC,N,CRP,IL-1,TNF-α),免疫相关参数(CD4,CD8,IgM,IgG)及肠道菌群(乳酸杆菌,肠球菌,双歧杆菌,大肠杆菌)数量。结果:术后,两组患者BMI及免疫相关因子表达相近。实验组营养评估参数PA,ALB,Hb显著高于对照组。对照组炎性反应相关参数明显高于实验组。实验组肠球菌及大肠杆菌含量低于对照组,而双歧杆菌和乳酸杆菌含量高于对照组。结论:序贯营养支持法可更有效的恢复患者营养状态,同时还可抑制术后应激反应,有利于患者康复。Objective:To evaluate the effect of sequential enteral nutrition support on nutritional status and anti-tumor immune response in patients with colorectal cancer surgery.Methods:In this prospective randomized controlled trial 154 patients who will under colorectal cancer surgery at our hospital between June 1st 2017 and May 31th 2018 were divided into sequential enteral nutrition support group(experiment group,n=77)and conventional nutrition support group(control group,n=77).Nutrition indicators(BMI,PA,ALB and Hb),immune indexes(IgM,IgG,CD4 and CD8),inflammatory response indicators(WBC,N,IL-1,CRP and TNF-α),numbers of intestinal flora(enterococcus,escherichia coli,bifidobacterium and lactobacillus)were measured before surgery and 3 days after surgery.Results:After surgery,BMI and inflammatory response indicators were balanced in both group.PA,ALB and Hb were higher in experiment group.All the inflammatory response indicators were higher in control group.Escherichia coli and enterococcus were lower in experiment group whereas bifidobacterium and lactobacillus were higher in experiment group.Conclusion:The sequential enteral nutrition support can effectively improve patients'nutritional status.Besides,sequential enteral nutrition support can inhibit the inflammatory response.

关 键 词：序贯营养支持 炎性反应 免疫反应 肠道菌群 

分 类 号：R735.3[医药卫生—肿瘤]