摘要
目的:探讨早期肠内营养对食管癌患者术后吻合口瘘的预防、免疫能力及营养状态的影响。方法:将选取的168例行食管癌切除术的患者随机分为两组,观察组给予早期肠内营养,对照组术后给予肠外营养,第5天开始给予肠内营养,观察并比较两组患者后吻合口瘘发生率、术后7d患者营养状况及免疫情况。结果:营养支持7d后观察组术后吻合口瘘发生率显著低于对照组,差异具有统计学意义;营养支持7d后观察组视黄醇结合蛋白、α1-抗胰蛋白酶、转铁蛋白显著高于治疗前,差异具有统计学意义,而观察组血清白蛋白、血清总蛋白、血红蛋白与治疗后相比没有出现显著下降;对照组治疗前较治疗后血清白蛋白、血清总蛋白、血红蛋白出现显著下降,差异具有统计学意义,对照组治疗后视黄醇结合蛋白、α1-抗胰蛋白酶、转铁蛋白显著高于治疗前;营养支持7d后观察组血清白蛋白、血清总蛋白、血红蛋白、α1-抗胰蛋白酶、转铁蛋白显著高于对照组,差异具有统计学意义,两组视黄醇结合蛋白差异不显著;营养支持7d后观察组CD3^+、CD3^+/CD4^+、CD4^+/CD8^+较治疗前均没有显著下降,而对照组CD3^+、CD3^+/CD4^+、CD4^+/CD8^+较治疗前均出现显著下降,差异具有统计学意义;营养支持7d后观察组CD3^+、CD3^+/CD4^+、CD4^+/CD8^+均显著高于对照组,差异具有统计学意义。结论:早期肠内营养有利于减少食管癌术后吻合口瘘的发生,有利于患者术后早期免疫力、营养状态的恢复。
Objective To investigate the effect of early enteral nutrition on the prevention,immune function and nutritional status of anastomotic leakage in patients with esophageal cancer.Method Totally 168 patients undergoing esophageal cancer resection were randomly divided into two groups.The observation group was given early enteral nutrition,the control group was given parenteral nutrition after operation,and enteral nutrition was given on the fifth day.Incidence of anastomotic leakage,postoperative patient nutritional status,and immune status 7 days after surgery between two groups were observed and compared.Result After treatment,retinol-binding protein,α1-antitrypsin,and transferrin were significantly higher than those before treatment.The serum albumin,total serum protein,hemoglobin,α1-antitrypsin and transferrin were significantly higher in the observation group than in the control group after 7 days of observation,and the difference was statistically significant.There was no significant difference in retinol binding protein between the two groups.After 7 days of nutritional support,there was no significant decrease in CD3+,CD3+/CD4+,and CD4+/CD8+in the observation group before treatment,while in control group,CD3+,CD3+/CD4+,CD4+/CD8+had a significant decrease before treatment,and the difference was statistically significant.After 7 days of nutritional support,the CD3+,CD3+/CD4+and CD4+/CD8+levels in the observation group were significantly higher than those in the control group,the difference was statistically significant.Conclusion Early enteral nutrition is beneficial to reduce the occurrence of anastomotic fistula after esophageal cancer,which is beneficial to the recovery of early immunity and nutritional status of patients.
作者
朱媛
蒋紫玥
彭纪芳
ZHU Yuan;JIANG Zi-yue;PENG Ji-fang(Thoracic Surgery,Jiangsu Province Hospital,Nanjing 210029,China)
出处
《中国食物与营养》
2018年第10期55-57,共3页
Food and Nutrition in China
基金
南京市科技计划项目(项目编号:201611005)
关键词
胃肠内营养
食管癌
手术
营养
免疫
gastrointestinal nutrition
esophageal cancer
surgery
nutrition
immunity
作者简介
朱媛(1985—),女,初级护师,研究方向:营养与健康;通信作者:彭纪芳(1980-),女,副主任护师,研究方向:健康管理。
