早期梯度递增法饮食管理方案对肝癌肝叶切除术后患者胃肠功能恢复及炎性应激反应水平的影响  

Effect of early gradient increment diet on gastrointestinal function recovery and inflammatory stress response in patients with hepatocellular carcinoma after hepatectomy

作　　者：邱立帅 翟景明[2] 李新颜 QIU Li-shuai;ZHAI Jing-ming;LI Xin-yan(Operating Room,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China;Department of Gastrointestinal Surgery,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院手术室,河南洛阳471000 [2]河南科技大学第一附属医院胃肠外科,河南洛阳471000

出　　处：《青岛医药卫生》2023年第3期232-236,共5页Qingdao Medical Journal

基　　金：河南省重点科技攻关项目,172102310406。

摘　　要：目的研究早期梯度递增法饮食管理方案对肝癌肝叶切除术后患者胃肠功能恢复、肝功能及炎性应激反应的影响。方法选取河南科技大学第一附属医院2020年10月至2022年10月期间107例肝癌肝叶切除术后患者采用随机数字表法分组,对照组53例给予常规围术期饮食管理,观察组54例采取早期梯度递增法饮食管理方案,对比两组患者胃肠功能恢复水平,炎性应激反应水平和肝功能。结果观察组首次排气时间、首次排便时间、肠鸣音恢复时间、术后住院时间分别为(8.11±3.25)h、(52.15±4.23)h、(34.66±3.52)h、(8.42±1.33)d,均低于对照组(1.61±3.48)h、(59.68±4.66)h、(39.56±3.84)h、(1.12±1.26)d,差异有统计学意义(P<0.05);与术前相比,两组患者术后3d C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均升高,且观察组CRP、IL-6水平分别为(58.62±5.23)pg/mL、(77.44±6.32)mg/L,均低于对照组(88.69±6.24)pg/mL、(132.34±8.26)mg/L,差异有统计学意义(P<0.05);术后1d和术后3d两组患者肝功能(Child-Pugh)分级比较,差异无统计学意义(P>0.05);术后5d和术后7d观察组患者Child-Pugh分级优于对照组,差异有统计学意义(P<0.05)。结论早期梯度递增法饮食管理方案能够有效降低肝癌肝叶切除术后患者炎性应激反应水平,促进胃肠功能恢复,保护肝功能,具有临床推广价值。Objective To investigate the effects of early gradient increment diet on gastrointestinal function recovery,liver function and inflammatory stress response in patients with hepatocellular carcinoma after hepatocellular carcinoma lobectomy.Methods A total of 107 patients with hepatocellular carcinoma after hepatectomy from the First Affiliated Hospital of Henan University of Science and Technology from October 2020 to October 2022 were divided by random number table method.53 patients in the control group were given routine perioperative diet management,and 54 patients in the observation group were given early gradient increment diet management.The gastrointestinal function recovery level of the two groups was compared.Inflammatory stress response levels and liver function.Results The first exhaust time,first defecation time,bowel sound recovery time and postoperative hospitalization time of the observation group were(8.11±3.25)h,(52.15±4.23)h,(34.66±3.52)h and(8.42±1.33)d,respectively.They were lower than the control group(1.61±3.48)h,(59.68±4.66)h,(39.56±3.84)h,(1.12±1.26)d,and the difference was statistically significant(P<0.05).Compared with pre-operation,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)in 2 groups were increased 3 days after operation,and the levels of CRP and IL-6 in observation group were(58.62±5.23)pg/mL and(77.44±6.32)mg/L,respectively.They were lower than the control group(88.69±6.24)pg/mL and(132.34±8.26)mg/L,and the difference was statistically significant(P<0.05).There was no significant difference in Child-Pugh classification between the two groups 1 day after surgery and 3 days after surgery(P>0.05).The Child-Pugh grading of observation group was better than control group 5d and 7d after surgery,and the difference was statistically significant(P<0.05).Conclusion The early gradient increment diet management scheme can effectively reduce the inflammatory stress response level of patients after hepatocellular carcinoma lobectomy,promote the recovery of gastrointe

关 键 词：早期梯度递增法 肝癌 应激反应 肝功能 肝叶切除术 

分 类 号：R459.3[医药卫生—治疗学] R735.7[医药卫生—临床医学]