胃肠手术后早期营养支持对病人T淋巴细胞亚群影响的研究及护理

Nursing and Influence of Early Gastroenteric Nutrition on T-lymphocyte Subgroup of Patients with Gastrointestinal Tract Operating

目的 探讨胃肠手术后早期营养支持对T淋巴细胞亚群变化和体液免疫功能指标的影响及其护理。方法 将胃肠手术病人分为营养组和对照组。营养组将胃肠管置入胃内,术后第一天开始滴入能全力,术后第7天停止灌注,病人进食半流饮食。对照组术后进行常规输液治疗,肠蠕动恢复后开始进食。采集外周静脉血,用流式细胞仪检测外周血T淋巴细胞亚群水平,用生化分析仪检测血清免疫球蛋白(IgA、IgG、IgM)水平。结果 营养组3 天内恢复肠蠕动占87%,平均住院天数10天,白蛋白降低者占12.5%;而对照组3 天内恢复肠蠕动占30%,平均住院天数14天,白蛋白降低者占70%。T淋巴细胞亚群水平:营养组CD3、CD4、CD8水平升高;其中CD3显著升高,与对照组比较差异有显著性(P < 0.05)。体液免疫功能指标:营养组IgA、IgG水平升高;其中IgG水平显著升高,与对照组比较差异有显著性(P <0.05)。结论 胃肠道术后早期肠内营养效果好,肠蠕动恢复早,住院时间短。细胞和体液免疫功能指标提高。

Objective To investigate the clinical effect of early gastroenteric nutrition in the patients with gastrointestinal tract operating, and probe its nursing. Methods A total of 70 patients were randomly divided into 2 groups： the gastroenteric nutrition group and the control group. Patients in the gastroenteric nutrition group were given Quannengli through gastric tube, and patients in the control group were given normal treatment. Then nutrition conditions were compared between the two groups.The levels of IgA, IgG, IgM and T-lymphocyte subgroup of all patients were determined. Results There was no operative death in both groups. The levels of CD3, CD4, CD8, IgA, IgG were higher in gastroenteric nutrition group than those in the controls. CD3 and IgG were significantly higher in gastroenteric nutrition group than in the controls. The days in hospital were （10±2.5） d in gastroenteric nutrition group and （14 ± 3. 1） d in the controls after operation. Conclusions The nutritional support is necessary in patients with gastrointestinal tract operating. With effective nursing method, the nutritional support can increase immunity function.