术前肠内营养对直肠癌患者术后肠道菌群、免疫功能及营养状态的影响  

The Influence of Preoperative Enteric Nutrition on the Postoperative Intestinal Flora,Immunofunction and Nutriture of Rectal Cancer Patients

作　　者：贾哲 JIA Zhe(Surgical Dept.,the Affiliated Hospital to Tianjin City's Academy of TCM and Pharmacology,Tianjin 300120)

机构地区：[1]天津市中医药研究院附属医院外科,天津300120

出　　处：《中国肛肠病杂志》2023年第1期18-21,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨术前肠内营养对直肠癌患者术后肠道菌群、免疫功能及营养状态的影响。方法:将86例行直肠癌根治术患者随机分为观察组和对照组,每组43例。对照组患者在术前给予传统方法进行肠道准备,观察组患者在对照组的基础上给予肠内营养,比较2组患者手术前后肠道菌群、免疫功能及对营养状态的影响。结果:手术前2组患者双歧杆菌、乳酸杆菌、大肠杆菌、肠球菌比较差异无统计学意义(P>0.05),手术后观察组患者双歧杆菌、乳酸杆菌均高于对照组(P<0.05),大肠杆菌低于对照组(P<0.05),而2组患者手术后肠球菌比较差异无统计学意义(P>0.05);手术前2组患者IgG、IgM、IgA水平比较差异无统计学意义(P>0.05),手术后观察组患者IgG、IgM、IgA水平均高于对照组(P<0.05);手术前2组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05),手术后观察组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)均高于对照组(P<0.05);手术前2组患者TP、PA、ALB、TF水平比较差异无统计学意义(P>0.05),手术后观察组患者TP、PA、ALB、TF水平均高于对照组(P<0.05)。结论:术前肠内营养能有效纠正直肠癌患者术后肠道菌群失衡,提高患者免疫功能和营养状态,值得临床推广应用。Objective To investigate the influence of preoperative enteric nurtrition on the postoperative intestinal flora,immunofunction and nutriture of patients with rectal cancer.Methods Randomly divided 80 patients with rectal cancer and to be subject to radical surgery in author’s hospital into control group(43 cases,before surgery received routine intestinal preparation)and observation group(43 cases,besides routine intestinal preparation,plus enteric nutrition before surgery);then,compared both groups’pre-and postoperative intestinal flora and immunofunction,as well as the influence on nutriture.Results Before surgery in bifibacterium,lactobacillus,E.coli,and entercoccus there was no statistical difference between the two groups(P>0.05);after surgery,in observation group bifibacterium and lactobacillus were higher than in control group,but E.coli lower(P<0.05,all);as for entercoccus no statistical difference(P>0.05).Before surgery in the levels of IgG,IgM and IgA there was no statistical difference between the two groups(P>0.05);but after surgery in the levels of above three factors observation group was higher than control group(P<0.05).Before surgery in the levels of CD3^(+)and CD4^(+),and CD4^(+)/CD8^(+)there was no statistical difference between the two groups(P>0.05);but after surgery,in the levels of CD3^(+)and CD4^(+),and CD4^(+)/CD8^(+)observation group was higher than control group(P<0.05).Before surgery,in the levels of TP,PA,ALB and TF there was no statistical difference between the two groups(P>0.05);but after surgery,the levels of observation group were higher than that of control group(P<0.05).Conclusion Preoperative enteric nutrition can effectively rectificate patients’postoperative imbalance of intestinal flora,enhance their immunofunction and nutriture,thus is worth to be popularized to use.

关 键 词：直肠癌 手术 肠内营养 肠道菌群 免疫功能 营养状态 

分 类 号：R735.37[医药卫生—肿瘤] R459.3[医药卫生—临床医学]