双歧杆菌三联活菌联合序贯早期肠内营养对胃癌术后病人免疫炎症指标及体脂代谢水平的影响  

Effects of bifidobacteria triad combined with sequential early enteral nutrition on immune inflammatory indicators and body fat metabolism in postoperative patients with gastric cancer

作　　者：季红敏 刘春芳[2] 王姗[3] 李亚军[4] 张梦媛 刘璐璐 李秀川[6] JI Hong-min;LIU Chun-fang;WANG Shan;LI Ya-jun;ZHANG Meng-yuan;LIU Lu-lu;LI Xiu-chuan(School of Nursing,Bengbu Medical College,Bengbu Anhui 233004;Department of Oncology Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233003,China;Department of Rehabilitation,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233003,China;Department of Critical Care Medicine,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233003,China;Department of Stomatology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233003,China;Department of Nursing,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233003,China)

机构地区：[1]蚌埠医学院护理学院,安徽蚌埠233004 [2]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233003 [3]蚌埠医学院第一附属医院康复科,安徽蚌埠233003 [4]蚌埠医学院第一附属医院重症医学科,安徽蚌埠233003 [5]蚌埠医学院第一附属医院口腔科,安徽蚌埠233003 [6]蚌埠医学院第一附属医院护理部,安徽蚌埠233003

出　　处：《蚌埠医学院学报》2023年第5期664-668,共5页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(KJ2020A0569);蚌埠医学院人文社会科学重点项目(2021byzd267sk)。

摘　　要：目的:探讨双歧杆菌三联活菌联合序贯早期肠内营养对胃癌术后免疫炎症指标及体脂代谢水平的影响。方法:采用随机抽样法选取择期手术的胃癌病人42例,分为观察组22例和对照组20例。对照组给予术前常规营养支持,术后给予早期肠内营养支持;观察组序贯早期肠内营养联合双歧杆菌三联活菌摄入。比较2组病人手术前后营养状态、免疫炎症反应指标、体脂代谢水平和术后胃肠功能状态。结果:术前2组病人营养指标、免疫和炎症指标及体脂代谢指标差异均无统计学意义(P>0.05)。术后7 d,观察组前白蛋白水平高于对照组(P<0.05),免疫球蛋白A、免疫球蛋G水平均明显高于对照组(P<0.01),C反应蛋白、白细胞介素6均明显低于对照组(P<0.01),基础代谢高于对照组(P<0.05)。术后观察组首次通气时间、首次通便时间、恢复经口进食时间和首次下床活动时间均明显优于对照组(P<0.01),腹泻、腹胀、恶心呕吐发生率均低于对照组(P<0.05~P<0.01)。结论:双歧杆菌三联活菌联合序贯早期肠内营养应用于胃癌术后病人,能改善病人短期营养状况,提高免疫功能,减轻炎症反应,促进胃肠功能恢复,减少胃肠道不良反应发生率。Objective:To investigate the effect of bifidobacterium triple viable bacteria combined with sequential early enteral nutrition on immune inflammatory index and body lipid metabolism level after gastric cancer operation.Methods:Forty-two patients with gastric cancer who underwent elective surgery were randomly selected and divided into experimental group(n=22)and control group(n=20).The control group was given routine nutritional support before operation and early enteral nutritional support after operation;in the experimental group,early enteral nutrition combined with intake of bifidobacterium triple viable bacteria was used in sequence.The differences in postoperative nutritional status,immune inflammatory reaction,body lipid metabolism level,and gastrointestinal function between the two groups were compared.Results:At baseline,there were no significant differences in the levels of nutrition,immunity and inflammation,metabolism between the two groups(P>0.05).After 7 days of surgery,the levels of PAB(P<0.05),IgA,IgG(P<0.01),and basal metabolism(P<0.05)in the study group were significantly higher than those in the control group.What′s more,the levels of CRP and IL-6 in study group were significantly lower than those in the control group(P<0.01).Additionally,The first time of passing flatus,bowel movement,oral feeding,ambulation(P<0.01)after surgery in the study group were significantly shorter than those in the control group.The incidence rate of diarrhea,abdominal distension,nausea and vomiting in study group were significantly lower than those in the control group(P<0.05 to P<0.01).Conclusions:The application of bifidobacterium triple viable bacteria combined with sequential early enteral nutrition can effectively improve the short-term nutritional status,immune function,reduce the inflammatory response,promote the recovery of gastrointestinal function,and reduce the incidence of gastrointestinal adverse reactions in postoperative patients with gastric cancer.

关 键 词：胃肿瘤 双歧杆菌三联活菌 序贯早期肠内营养 免疫 体脂代谢 

分 类 号：R735.2[医药卫生—肿瘤]