围手术期使用免疫增强型肠内营养剂对大肠癌根治性切除术后患者的影响  

Effect of Perioperative Period Use of Immune-enhancing Type Enteral Nutrition on Patients with Radical Resection of Colorectal Cancer

作　　者：郭智[1] 劳景茂[1] 刘广 邓伟[1] 韦小波[1] 简文红 GUO Zhi;LAO Jingmao;LIU Guang;DENG Wei;WEI Xiaobo;JIAN Wenhong(Qinzhou First People's Hospital,Qinzhou 535000,China;不详)

机构地区：[1]钦州市第一人民医院,广西钦州535000

出　　处：《中外医学研究》2023年第34期15-19,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广西壮族自治区临床重点专科建设项目(桂卫医发[2022]17号);广西壮族自治区卫健委自筹经费科研课题项目(Z 20211103)。

摘　　要：目的:观察大肠癌根治性切除术患者围手术期使用免疫增强型肠内营养剂的效果。方法:选择2019年7月—2022年6月钦州市第一人民医院120例行大肠癌根治性切除术患者,随机分为两组,各60例。对照组围手术期给予常规肠外营养支持治疗,试验组围手术期给予免疫增强型肠内营养剂治疗。比较两组的营养指标、免疫指标、炎症指标及住院天数。结果:术前1 d,两组转铁蛋白(TFN),血清白蛋白(ALB)及前白蛋白(PA)比较,差异无统计学意义(P>0.05);术后7 d,试验组TFN、ALB、PA水平高于对照组,差异有统计学意义(P<0.05)。术前1 d,两组血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较,差异无统计学意义(P>0.05);术后7 d,试验组血清IgG、IgM、IgA、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。术前1 d,两组C反应蛋白(CRP)、白细胞介素-6(IL-6)比较,差异无统计学意义(P>0.05);术后7 d,试验组CRP、IL-6低于对照组,差异有统计学意义(P<0.05)。试验组住院天数为(12.45±2.21)d,短于对照组的(13.93±2.86)d,差异有统计学意义(t=-3.172,P=0.002)。结论:大肠癌根治性切除术患者围手术期使用免疫增强型肠内营养剂,能够改善营养状态,提高免疫功能,缓解炎症反应,促进机体康复,缩短住院时间。Objective:To observe the effect of immune-enhancing type enteral nutrition during perioperative period in patients with radical resection of colorectal cancer.Method:A total of 120 patients who underwent radical resection of colorectal cancer in Qinzhou First People's Hospital from July 2019 to June 2022 were selected,and they were randomly divided into two groups,with 60 patients in each group.The control group was given routine parenteral nutrition support treatment during perioperative period,and the experimental group was given immune-enhanced type enteral nutrition treatment during perioperative period.The nutritional indexes,immune indexes,inflammatory indexes and length of stay were compared between the two groups.Result:At 1 d before surgery,there were no significant differences in transferrin(TFN),serum albumin(ALB)and prealbumin(PA)between the two groups(P>0.05).At 7 d after surgery,the levels of TFN,ALB and PA in the experimental group were higher than those in the control group,the differences were statistically significant(P<0.05).At 1 d before surgery,there were no significant differences in serum immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05).At 7 d after surgery,serum IgG,IgM,IgA,CD4^(+),CD4^(+)/CD8^(+)+in experimental group were higher than those in control group,and CD8 was lower than that in control group,the differences were statistically significant(P<0.05).At 1 d before surgery,there were no significant differences in C-reactive protein(CRP)and interleukin-6(IL-6)between the two groups(P>0.05),At 7 d after surgery,CRP and IL-6 in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).The length of hospitalization in experimental group was(12.45±2.21)d,which was shorter than(13.93±2.86)d in control group,and the difference was statistically significant(t=-3.172,P=0.002).Conclusion:Perioperative period use of immune-enhancing type enteral nutritio

关 键 词：围手术期 大肠癌 免疫增强型肠内营养剂 营养状态 免疫功能 炎症反应 住院时间 

分 类 号：R735.34[医药卫生—肿瘤]