本文選題：胃癌 + 營養(yǎng)風(fēng)險�。� 參考：《四川大學(xué)學(xué)報(醫(yī)學(xué)版)》2017年03期

【摘要】：目的探討早期腸內(nèi)免疫營養(yǎng)對胃癌伴營養(yǎng)風(fēng)險患者術(shù)后營養(yǎng)狀態(tài)和免疫功能的影響。方法將2014年2~12月期間四川大學(xué)華西醫(yī)院胃腸外科新入院胃癌患者運用NRS 2002進行營養(yǎng)風(fēng)險篩查,將評分在3~5分的患者隨機分為試驗組(術(shù)后早期給予含谷氨酰胺的腸內(nèi)營養(yǎng),30例)和對照組(術(shù)后早期給予普通腸內(nèi)營養(yǎng),30例),兩組術(shù)后給予7d營養(yǎng)支持。兩組患者分別于術(shù)前1天和術(shù)后第3、7天空腹采集外周靜脈血,用于檢測細胞免疫指標(CD3~+、CD4~+、CD8~+和CD4~+/CD8~+比值)、營養(yǎng)狀態(tài)指標(血漿轉(zhuǎn)鐵蛋白、前白蛋白、白蛋白水平)。同時觀察記錄術(shù)后首次肛門排氣時間、術(shù)后住院期間肺部感染、炎性腸梗阻、術(shù)后住院時間等。結(jié)果術(shù)后第3天和術(shù)后第7天試驗組患者CD4~+/CD8~+、轉(zhuǎn)鐵蛋白、血漿前白蛋白、白蛋白水平均高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。與對照組相比,試驗組患者術(shù)后肛門首次排氣時間提前[(63.5±7.3)h vs.(72.8±8.6)h],差異有統(tǒng)計學(xué)意義(P0.05)。但肺部感染、吻合口瘺、嚴重腹脹、炎性腸梗阻等方面,組間差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論早期腸內(nèi)免疫營養(yǎng)促進了胃癌伴營養(yǎng)風(fēng)險患者術(shù)后免疫功能的恢復(fù)和血清前白蛋白、白蛋白水平的回升,促進了患者術(shù)后腸道功能的恢復(fù)和術(shù)后的康復(fù)。
[Abstract]:Objective to investigate the effect of early enteral immune nutrition on postoperative nutritional status and immune function in patients with nutritional risk of gastric cancer. Methods NRS 2002 was used to screen the nutritional risk of newly admitted gastric cancer patients in West China Hospital of Sichuan University from February to December 2014. Patients with a score of 3 ~ 5 were randomly divided into trial group (30 cases of early postoperative enteral nutrition containing glutamine) and control group (30 cases of common enteral nutrition). The two groups were given 7 days nutritional support after operation. The peripheral venous blood was collected on an empty stomach 1 day before operation and 3 days after operation in both groups. The levels of CD3 ~ + CD4 ~ + CD8 ~ and CD4 ~ / CD8 ~ and nutritional status (plasma transferrin, prealbumin, albumin) were measured. At the same time, the first time of anal exhaust after operation, pulmonary infection, inflammatory intestinal obstruction and postoperative hospitalization time were recorded. Results the levels of CD4 ~ / CD8 ~, transferrin, plasma prealbumin and albumin in the trial group were significantly higher than those in the control group on the 3rd day and 7th day after operation, and the difference was statistically significant (P 0.05). Compared with the control group, the first time of anus exhaust in the experimental group was earlier than that in the control group [63.5 鹵7.3 h vs.(72.8 鹵8.6 h], and the difference was statistically significant (P 0.05). However, there was no significant difference in pulmonary infection, anastomotic fistula, severe abdominal distension and inflammatory intestinal obstruction between the two groups (P 0.05). Conclusion early enteral immune nutrition can promote the recovery of postoperative immune function and the rise of serum prealbumin and albumin levels in patients with gastric cancer associated with nutritional risk, and promote the recovery of postoperative intestinal function and postoperative recovery.
【作者單位】： 四川大學(xué)華西醫(yī)院胃腸外科;成都三六三醫(yī)院胃腸外科;
【基金】：四川省科技廳科技支撐計劃項目(No.2013FZ0091)資助
【分類號】：R735.2

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