直肠癌根治术后早期应用不同制剂型肠内营养对患者营养、胃肠道功能、康复进程和炎症介质的影响  

Effects of Early Application of Different Preparations of Enteral Nutrition on Patients’Nutrition,Gastrointestinal Function,Recovery Process and Inflammatory Mediators After Radical Rectal Cancer Surgery

作　　者：杨绪兰 余友敏 李佳雯 赵小晶 YANG Xulan;YU Youmin;LI Jiawen;ZHAO Xiaojing(Dept.of Nutriology,920th Hospital of Joint Logistics Support Force of PLA,Kunming 650032,China)

机构地区：[1]中国人民解放军联勤保障部队第九二〇医院营养科,昆明650032

出　　处：《中国医院用药评价与分析》2022年第10期1189-1192,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：云南省科技厅科技计划项目(No.202101AT07002)。

摘　　要：目的:探讨早期不同制剂型肠内营养序贯应用对直肠癌根治术患者营养、胃肠道功能、康复进程和炎症介质的影响。方法:按照随机信封法和1∶1研究设计原则,将2020年1月至2022年1月该院收治的拟行结直肠癌根治术患者88例均分为对照组(44例,给予整蛋白型肠内营养)、序贯组(44例,序贯应用氨基酸型、短肽型和整蛋白型肠内营养)。比较两组患者的营养指标水平[体重、前白蛋白(PA)、总蛋白(TP)和血清白蛋白(ALB)]、胃肠功能指标水平[血清生长抑素(SS)、胃泌素(GAS)、血管活性肠肽(VIP)和胃动素(MTL)]、肛门排气时间、进食时间、首次排便时间、首次下床时间、住院时间、炎症介质水平[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)6、IL-1、C反应蛋白(CRP)和IL-8]及并发症发生情况。结果:两组患者术后7 d体重、PA、TP和ALB水平均较术前降低,但序贯组患者高于对照组,差异均有统计学意义(P<0.05)。序贯组患者术后7 d的SS水平低于对照组,GAS、VIP和MTL水平高于对照组,肛门排气时间、进食时间、首次排便时间、首次下床时间和住院时间短于对照组,差异均有统计学意义(P<0.05)。两组患者术后7 d的TNF-α、IL-6、IL-1、CRP和IL-8水平较术前升高,但序贯组患者低于对照组,差异均有统计学意义(P<0.05)。序贯组患者的并发症总发生率为4.55%(2/44),与对照组(11.36%,5/44)比较,差异无统计学意义(P>0.05)。结论:早期不同制剂型肠内营养序贯应用,可改善直肠癌根治术患者的营养状态、胃肠道动力和炎症反应,促进胃肠道功能恢复,加快患者康复进程,安全可靠。OBJECTIVE:To probe into the effects of early sequential application of different formulations of enteral nutrition on nutrition,gastrointestinal function,rehabilitation process and inflammatory mediators in patients undergoing radical resection of rectal cancer.METHODS:According to the randomized envelope method and the principle of 1∶1 trial design,88 patients undergoing radical resection of colorectal cancer from Jan.2020 to Jan.2022 were divided into the control group(44 cases,given whole protein enteral nutrition),the sequential group(44 cases,sequential application of amino acid-based,short peptide and whole protein-based enteral nutrition).Nutritional indicators[body weight,prealbumin(PA),total protein(TP)and serum albumin(ALB)],gastrointestinal function indicators[serum growth inhibition(SS),gastrin(GAS),vasoactive intestinal peptide(VIP)and gastrin(MTL)],anal evacuation time,feeding time,first defecation time,first time out of bed,length of stay,inflammatory mediators[tumor necrosis factor alpha(TNF-α),interleukin(IL)6,IL-1,C-reactive protein(CRP)and IL-8]and complications of two groups were compared.RESULTS:After surgery of 7 d,the body weight,PA,TP and ALB levels of two groups were lower than those before surgery,yet the sequential group was higher than the control group,the differences were statistically significant(P<0.05).After surgery of 7 d,the SS level of sequential group was lower than that of control group,the GAS,VIP and MTL levels were higher than those of control group,and the anal evacuation time,feeding time,first defecation time,first time out of bed,length of stay were shorter than those of control group,the differences were statistically significant(P<0.05).After surgery of 7 d,the TNF-α,IL-6,IL-1,CRP and IL-8 levels in two groups were higher than those before surgery,yet the sequential group was lower than the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the sequential group was 4.55%(2/44),compared with 11.36%(5/44)in

关 键 词：早期不同制剂型肠内营养 序贯 直肠癌根治术 营养 胃肠道功能 炎症介质 

分 类 号：R977[医药卫生—药品]