经皮胃造瘘术联合特殊医学用途配方食品对晚期恶性肿瘤病人免疫功能及营养状况的影响  

Effects of percutaneous gastrostomy combined with formula food for special medical purposes on immune function and nutritional status in patients with advanced malignant tumors

作　　者：白利君 杨波 刘荣新 BAI Lijun;YANG Bo;LIU Rongxin(Department of Oncology,Qinhuangdao Military Industrial Hospital,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛军工医院肿瘤科,河北秦皇岛066000

出　　处：《安徽医药》2022年第6期1167-1170,共4页Anhui Medical and Pharmaceutical Journal

基　　金：秦皇岛市科技计划项目(201902A136)。

摘　　要：目的观察数字减影血管造影(DSA)引导下经皮胃造瘘术联合特殊医学用途配方食品对吞咽障碍的晚期恶性肿瘤病人免疫功能及营养状况的影响。方法选取2018年1月至2020年1月秦皇岛军工医院收治的行胃造瘘术的吞咽障碍的晚期恶性肿瘤病人100例,采用随机数字表法分为观察组(脱落2例,n=48)与对照组(脱落3例,n=47),观察组采用经DSA引导下经皮胃造瘘术并联合特殊医学用途配方食品治疗方案,对照组采用传统胃造瘘术治疗。比较两组病人治疗前及治疗1个月后免疫功能指标及营养状况变化情况。结果治疗前,两组病人免疫功能评价指标及营养状况评价指标比较,均差异无统计学意义(P>0.05);治疗1个月后,观察组免疫功能指标CD3^(+)、CD4^(+)、免疫球蛋白(Ig)G、IgM、IgA高于治疗前,且观察组CD3^(+)[(66.11±8.59)%]、CD4^(+)[(38.87±8.61)%]、IgG[(15.82±5.04)g/L]、IgM[(1.44±0.46)g/L]、IgA[(2.61±0.19)g/L]高于对照组[(62.53±8.36)%、(35.41±7.31)%、(13.94±4.91)g/L、(1.26±0.41)g/L、(2.49±0.15)g/L];CD8^(+)低于治疗前,且观察组CD8^(+)[(27.01±3.42)%]低于对照组[(28.57±3.81)%],均差异有统计学意义(P<0.05);治疗1个月后,观察组营养状况评价指标肱三头肌皮皱厚(TSF)、上臂肌围、去脂体质量指数(FFMI)、血红蛋白、白蛋白、前白蛋白高于治疗前,且观察组TSF[(16.57±7.22)mm]、上臂肌围[(25.97±4.84)cm]、FFMI[(18.82±3.74)kg/m^(2)]、血红蛋白[(148.77±33.64)g/L]、白蛋白[(43.76±7.97)g/L]、前白蛋白[(347.46±83.64)mg/L]高于对照组[(13.62±7.13)mm、(23.69±4.78)cm、(16.71±3.66)kg/m^(2)、(131.81±30.19)g/L、(39.26±8.25)g/L、(309.83±79.61)mg/L](P<0.05)。结论DSA引导下经皮胃造瘘术联合特殊医学用途配方食品治疗能够有效提高吞咽障碍的晚期恶性肿瘤病人免疫功能,改善病人营养状况,推荐临床应用。Objective To observe the effects of DSA-guided percutaneous gastrostomy combined with formula food for special medical purposes on the immune function and nutritional status of patients with advanced malignant tumors with dysphagia.Methods A total of 100 dysphagia patients with advanced malignant tumors who underwent gastrostomy in Qinhuangdao Military Industrial Hospital from January 2018 to January 2020 were selected and randomly divided into the observation group(2 cases of abscision,n=48)and the control group(3 cases of abscision,n=47)by using the random number table method.The observation group was treated with DSA guided percutaneous gastrostomy combined with special medical formula and the control group was treated with traditional gastrostomy.The changes of the levels of immune function and nutritional status of patients in the two groups were compared before treatment and 1 month after treatment.Results Before treatment,there was no significant difference in the evaluation indexes of immune function and nutritional status between the two groups(P>0.05).After 1 month of treatment,the immune function indexes CD3^(+),CD4^(+),IgG,IgM and IgA in the observation group were higher than those before treatment,and the CD3^(+)[(66.11±8.59)%],CD4^(+)[(38.87±8.61)%],IgG[(15.82±5.04)g/L],IgM[(1.44±0.46)g/L],IgA[(2.61±0.19)g/L]in the observation group were higher than those in the control group[(62.53±8.36)%,(35.41±7.31)%,(13.94±4.91)g/L,(1.26±0.41)g/L,(2.49±0.15)g/L],and the CD8^(+) was lower than that before treatment,and the CD8^(+)[(27.01±3.42)%]in the observation group was lower than that in the control group[(28.57±3.81)%](P<0.05).After 1 month of treatment,the nutritional status evaluation indicators TSF,AMC,FFMI,Hb,ALB,PA in the observation group were higher than those before treatment,and the TSF[(16.57±7.22)mm],AMC[(25.97±4.84)cm],FFMI[(18.82±3.74)kg/m^(2)],Hb[(148.77±33.64)g/L],ALB[(43.76±7.97)g/L],PA[(347.46±83.64)mg/L]in the observation group were higher than those in the control group[(

关 键 词：肠道营养 胃造口术 食品 配方 肿瘤 吞咽障碍 血管造影术 数字减影 经皮胃造瘘术 食品 专用 免疫功能 营养状况 

分 类 号：R730.5[医药卫生—肿瘤] R459.3[医药卫生—临床医学]