结构脂肪乳用于胃癌术后肠外营养的效果及对免疫功能、肝功能的影响  

Application of structured lipid emulsion in postoperative parenteral nutrition and its influence on immune function and liver function in patients with gastric cancer

作　　者：何志光 王新维 赵磊[1] 李震[1] He Zhiguang;Wang Xinwei;Zhao Lei;Li Zhen(Department of Western Medicine Pharmacy,Nanyang Central Hospital,Nanyang 473000,China;Ward Ⅱ Department of General Surgery Gastrointestinal,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院西药药学部,南阳473000 [2]南阳市中心医院普通外科胃肠二病区,南阳473000

出　　处：《中国实用医刊》2022年第21期108-111,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨结构脂肪乳用于胃癌术后肠外营养的效果及其对免疫功能、肝功能的影响。方法抽取2020年10月至2021年11月南阳市中心医院收治的胃癌患者94例,按随机数字表法分为研究组与对照组,每组47例。所有患者均行胃癌根治术,术后均予以肠外营养支持。对照组肠外营养采用20%中/长链脂肪乳,研究组采用结构脂肪乳。比较两组术后恢复情况;术前、术后3 d、术后7 d,比较两组蛋白质代谢情况[转铁蛋白(TRF)、前白蛋白(PA)、白蛋白(ALB)]、细胞免疫功能(T淋巴细胞亚群CD3^(+)、CD4^(+))、体液免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]及肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)]。结果研究组肛门排气时间、下床活动时间、术后住院时间均短于对照组(P均<0.05)。术后3、7 d,两组TRF、PA、ALB水平均较术前增高,且研究组增高幅度高于对照组(P<0.05);两组CD3^(+)、CD4^(+)、IgA、IgG、IgM水平均较术前降低,但研究组降低幅度低于对照组(P<0.05);两组ALT、TBiL水平均较术前降低,且研究组低于对照组(P<0.05)。结论胃癌术后采用结构脂肪乳进行肠外营养支持,可改善患者的蛋白质代谢和营养状况,改善免疫功能和肝功能,加快机体恢复。Objective To investigate the effects of structured lipid emulsion on postoperative parenteral nutrition and its influence on immune function and liver function in patients with gastric cancer.Methods A total of 94 patients with gastric cancer treated in Nanyang Central Hospital from October 2020 to November 2021 were selected,and they were divided into study group and control group by random number table method,with 47 cases in each group.All patients underwent radical gastrectomy,and were given parenteral nutrition support after operation.The control group used 20% medium/long chain lipid emulsion for parenteral nutrition,and the study group used structured lipid emulsion for parenteral nutrition.The postoperative recovery of the two groups were compared.The protein metabolism including transferrin(TRF),prealbumin(PA)and albumin(ALB),cellular immune function assessed by T lymphocyte subsets cluster of differentiation 3^(+)(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+)),humoral immune function assessed by immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM),liver function assessed by alanine transaminase(ALT)and total bilirubin(TBiL)were compared between the two groups before operation,3 days after operation and 7 days after operation.Results Anal exhaust time,postoperative activity time and postoperative hospital stay in the study group were shorter than those in the control group(all P<0.05).Three and 7 days after operation,the levels of TRF,PA and ALB in both groups were higher than those before operation,and the increase of the above indicators in the study group were higher than those in the control group(P<0.05);the levels of CD3^(+),CD4^(+),IgA,IgG,and IgM in both groups were all lower than those before operation,but the decrease of the above indicators in the study group were lower than those in the control group(P<0.05);levels of the ALT and TBiL in both groups were lower than those before operation,and the above indicators in the study group were lower than those in the control gr

关 键 词：胃癌 结构脂肪乳 肠外营养 免疫功能 肝功能 

分 类 号：R735.2[医药卫生—肿瘤]