摘要
目的:探讨肠内营养联合肠外营养对食管癌术后患者免疫功能、营养状况的影响,并观察其对临床结局和生活质量的影响。方法:选取2015年5月—2018年3月就诊于我院确诊为食管癌行食管癌根治术的患者106例,按照随机数字表法分为试验组和对照组,每组患者53例,对照组患者术后行单纯肠外营养(TPN组)7d,观察组患者术后行肠内营养联合肠外营养(EEN+PN组)7d,对两组患者行营养支持期间的免疫学指标[淋巴细胞计数(LYM)、免疫球蛋白A(lgA)、免疫球蛋白M(lgM)、免疫球蛋白G(lgG)]、营养指标(白蛋白、转铁蛋白、前白蛋白)、住院情况(肛门排气时间、排便时间、术后住院时间以及住院费用)以及并发症等情况进行比较。结果:(1)两组患者营养治疗后免疫学指标(LYM、lgA、lgA及lgG)较前均有所改善,且试验组改善程度显著高于对照组;(2)两组患者营养治疗后其营养学指标(白蛋白、前白蛋白、转铁蛋白)较前均有所提高,试验组患者营养学指标显著高于对照组;(3)试验组患者首次肛门排气时间、排便时间、术后住院时间较对照组明显缩短,试验组患者住院费用显著低于对照组;(4)两组患者营养支持期间并发症发生率之间差异不显著。结论:早期肠内营养联合肠外营养能够提高患者围术期的免疫功能,改善术后营养状况,促进疾病的康复,提高患者的生活质量。
Objective To investigate the effect of enteral nutrition combined with parenteral nutrition on the immune function and nutritional status of patients with esophageal cancer after operation,and observe its effect on clinical outcome.Method We selected 106 patients diagnosed with esophageal cancer in May 2015 to March 2018 clinic in our hospital.According to random number table method,they were divided into experimental group and the control group,each group of 53 cases,patients with the control group patients postoperative line pure parenteral nutrition(TPN)7 d,line observation group of patients with postoperative enteral nutrition in combination with parenteral nutrition(EEN+PN group)7 d.On two groups of patients with nutritional support during the immunological indexes of[lymphocyte count(LYM)of immunoglobulin A(lgA),immunoglobulin M(lgM),igg(lgG)],nutrition index(albumin,transferrin and prealbumin),hospitalization(anal exhaust time,defecation time,length of hospital stay and postoperative hospitalization expenses)and complications,and so on and so forth.Result Immunological indexes(LYM,lgA,lgA and lgG)of the two groups were improved after nutritional treatment,and the improvement degree of the experimental group was significantly higher than that of the control group(P<0.05).After nutritional treatment,the nutritional indexes(albumin,prealbumin,transferrin)of patients in the two groups were improved,and the improvement of nutritional indexes in the experimental group was significantly higher than that in the control group(P<0.05).The first anal exhaust time,defecation time and postoperative hospitalization time of the test group were significantly shorter than that of the control group,and the hospitalization cost of the test group was significantly lower than that of the control group(P<0.05).There was no significant difference between the two groups in the incidence of complications during nutritional support(P>0.05).[Conclusion]Compared with total parenteral nutrition,early enteral nutrition combined with parenteral nutrition can improve perioperative immune function,improve postoperative nutritional status,promote disease recovery and improve patients'quality of life.
作者
武洋
王珺
刘薇
李美丽
董跃华
WU Yang;WANG Jun;LIU Wei;LI Mei-li;DONG Yue-hua(Cardio-Thoracic Surgery,Beijing Shijitan Hospital,CMU,Capital Medical University,Beijing 100038,China;Cardio-Thoracic Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《中国食物与营养》
2020年第1期82-85,共4页
Food and Nutrition in China
基金
首都医科大学附属北京世纪坛医院院青年基金(项目编号:2017-q11)。
关键词
早期肠内营养
肠外营养
免疫功能
营养状况
生活质量
early enteral nutrition
parenteral nutrition
immune function
nutritional status
quality of life
