肠内肠外营养治疗对结直肠癌患者免疫及肠道菌群的影响  

Effects of enteral and parenteral nutritional support on immunity and intestinal flora in patients undergoing colorectal cancer

作　　者：王玥 梁峰[1] 马海燕[1] 武雪亮[1] 张伟[2] 郭飞[1] Wang Yue;Liang Feng;Ma Haiyan;Wu Xueliang;Zhang Wei;Guo Fei(Department of General Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Central Laboratory,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院普通外科,河北张家口075000 [2]河北北方学院附属第一医院中心实验室,河北张家口075000

出　　处：《肿瘤代谢与营养电子杂志》2022年第3期374-379,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：河北省财政厅临床医学优秀人才培养项目(361009);河北省卫生计生委医学科学研究重点课题计划项目(20180863);张家口市科技局指导性项目(2121104D)。

摘　　要：目的探究术后肠内营养联合肠外营养治疗对结直肠癌患者免疫功能及肠道菌群的影响。方法选取河北北方学院附属第一医院2019年1月至2021年5月收治的结直肠癌手术治疗患者90例,使用随机数字表法将所有患者分为对照组和研究组,每组45例,对照组给予肠外营养干预,研究组给予肠内营养联合肠外营养干预。比较两组患者干预前后营养状况、CD细胞、免疫蛋白、肠道菌群水平和临床指标。结果干预前,两组血清总蛋白(TP)、血清白蛋白(ALB)、转铁蛋白(Tf)、血红蛋白(Hb)和体质指数(BMI)水平差异无统计学意义(P>0.05);干预后,研究组TP、ALB、Tf、Hb和BMI水平显著高于对照组(P<0.05)。干预前,两组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平差异无统计学意义(P>0.05);干预后,研究组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平显著高于对照组(P<0.05)。干预前,两组IgA、IgG和IgM水平差异无统计学意义(P>0.05);干预后,研究组IgA、IgG和IgM水平显著高于对照组(P<0.05)。干预前,两组乳杆菌、拟杆菌、真杆菌、双歧杆菌、球杆菌和大肠埃希菌数量的差异无统计学意义(P>0.05);干预后,研究组乳杆菌、拟杆菌和双歧杆菌数量显著高于对照组,球杆菌和大肠埃希菌数量显著低于对照组(P<0.05)。研究组开始进食、肛门排气时间和住院时间显著低于对照组(P<0.05)。结论肠内营养联合肠外营养治疗能有效提高患者细胞免疫和体液免疫功能,调节患者肠道菌群,改善结直肠癌患者临床指标,促进患者术后恢复。Objective To investigate the effect of postoperative parenteral and parenteral nutritional support on immunity and intestinal flora in patients with colorectal cancer.Method A total of 90 patients with colorectal cancer who were treated in the First Affiliated Hospital of Hebei Northern University from January 2019 to May 2021 were selected.All patients were divided into a control group and a research group by random number table method,with 45 cases in each group.The control group was given parenteral nutrition intervention,and the research group was given enteral nutrition combined with parenteral nutrition intervention.The nutritional status,CD cells,immune proteins,intestinal flora levels and clinical indicators before and after intervention were compared between the two groups.Result There was no significant difference in the levels of serum total protein(TP),serum albumin(ALB),transferrin(Tf),hemoglobin(Hb)and body mass index(BMI)between the two groups before the intervention(P>0.05);after the intervention,the levels of TP,ALB,Tf,Hb and BMI in the research group were significantly higher than those in the control group(P<0.05),The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups before intervention were not significantly different(P>0.05);the levels of CD3^(+),CD4^(+)and CD4/CD8^(+)in the research group after the intervention were significantly higher than those in the control group(P<0.05).There was no significant difference in the levels of IgA,IgG and IgM between the two groups before the intervention(P>0.05);after the intervention,the levels of IgA,IgG and IgM in the research group were significantly higher than those in the control group(P<0.05).There was no significant difference in the number of Lactobacillus.Bacteroides,Eubacterium^BifidobacteriumCoc-cobacillus and Escherichia coli between the two groups before the intervention(P>0.05);after the intervention,the number of Lactobacillus,Bacteroides and Bifidobacterium in the research group was significantly higher than that in the contro

关 键 词：肠内营养 肠外营养 结直肠癌 CD细胞 免疫蛋白 肠道菌群 

分 类 号：R735.34[医药卫生—肿瘤] R459.3[医药卫生—临床医学]