肠外营养支持中添加结构脂肪乳对胃癌患者术后胃肠功能恢复、免疫功能及肝功能的影响  

Effects of parenteral nutrition support with structured fat emulsion on postoperative recovery of gastrointestinal function,immune function and liver function in patients with gastric cancer

作　　者：丁晓平[1] 侯艳[1] 姜如月 DING Xiao-ping;HOU Yan;JIANG Ru-yue(Department of Nutrition,Eastern Branch,Qingdao Municipal Hospital,Qingdao 266071,Shandong,China)

机构地区：[1]青岛市市立医院东院营养科,山东青岛266071

出　　处：《川北医学院学报》2023年第12期1697-1701,共5页Journal of North Sichuan Medical College

摘　　要：目的:探讨肠外营养支持中添加结构脂肪乳对胃癌患者术后胃肠功能恢复、免疫功能及肝功能的影响。方法:回顾性分析186例胃癌行手术治疗患者的临床资料,将给予结构脂肪乳的患者纳入A组(n=95);给予中/长链脂肪乳者纳入B组(n=91)。肠外营养支持6 d后,比较两组患者营养指标、胃肠激素、炎性指标、肝功能、免疫功能水平和不良反应发生情况。结果:肠外营养支持6 d后,A组血清总蛋白(TP)、白蛋白(Alb)、转铁蛋白(Trf)、前白蛋白(Palb)均高于B组(P<0.05);血浆胃动素(MOT)、促胃液素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、PGⅠ/PGⅡ水平均高于B组(P<0.05);血CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平均高于B组(P<0.05);白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)低于B组(P<0.05);丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和直接胆红素(DBIL)水平均低于B组(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:结构脂肪乳用于胃癌术后肠外营养可改善患者营养状态,加快胃肠功能恢复,减轻患者炎性反应,提高免疫功能,患者术后肝功能异常风险降低。Objective:To explore the effects of parenteral nutrition support with structured fat emulsion on postoperative recovery of gastrointestinal function,immune function and liver function in patients with gastric cancer.Methods:A retrospective analysis was performed on the clinical data of 186 patients with gastric cancer who underwent surgical treatment,including 95 cases in group A(structured fat emulsion)and 91 cases in group B(medium/long chain fat emulsion).After 6 d of parenteral nutrition support,the nutritional indicators,gastrointestinal hormones,inflammatory indicators,liver function,immune function levels,and adverse reactions were compared between the two groups.Results:After 6 d of parenteral nutrition support,levels of serum total protein(TP),albumin(Alb),transferrin(Trf)and prealbumin(Palb)in group A were higher than those in group B(P<0.05).The levels of plasma motilin(MOT),gastrin(GAS),pepsinogen I(PG I)and PG I/PG II in group A were higher than those in group B(P<0.05).The levels of serum CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in group A were higher than those in group B(P<0.05),levels of interleukin 6(IL-6),tumor necrosis factorα(TNF-α)and C-reactive protein(CRP)in group A were lower than those in group B(P<0.05),and levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and direct bilirubin(DBIL)in group A were lower than those in group B(P<0.05).The difference in incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:The application of structured fat emulsion in parenteral nutrition can improve nutritional status of patients after gastric cancer surgery,accelerate the recovery of gastrointestinal function,alleviate inflammatory response and improve immune function,with low risk of postoperative liver dysfunction.

关 键 词：胃癌 肠外营养 结构脂肪乳 免疫功能 肝功能 

分 类 号：R735[医药卫生—肿瘤]