黄芪联合早期肠内营养对阻塞性黄疸术后营养状况和免疫功能的影响

The effects of EEN therapy enhanced by Radix astragali on the nutritional and immune states in postoperative patients with obstructive jaundice

目的:研究黄芪加强的早期肠内营养(EEN)对阻塞性黄疸病人术后营养、肝功能和免疫功能的改善作用,以及对临床预后的影响。方法:将26例阻塞性黄疸术后病人随机分成三组,EN组病人术后肠道通气后给予EN液;EN+黄芪(EN+H)组病人术后给予黄芪,肠道通气后给予EN液;EEN+黄芪(EEN+H)组病人术后6 h即给予黄芪和EN液。结果:术后第1天三组病人的营养指标和淋巴细胞计数(LYM)较术前明显降低(P<0.05),且谷丙转氨酶显著增高(P<0.05)。术后第7天,EEN+H组血浆ALB、PA、IgG水平较EN+H组均有显著升高(P<0.05),肠道通气时间、住院时间、住院总费用、营养治疗费用有显著差异(P<0.05);EEN+H组血浆ALB、PA、肝功能指标、LYM、IgG和IgA水平均较EN组有显著性差异(P<0.05),肠道通气时间、住院时间、住院总费用、营养治疗费用和术后第3天感染评分亦有显著性差异(P<0.05)。结论:黄芪加强的EEN可有效地改善病人的营养、免疫功能和肝功能,降低术后感染并发症的发生率,促进肠功能恢复,缩短住院时间。

Objective ： To study the role of radix astragali and EEN therapy improving the nutritional, he- patic and immune states and clinical prognosis in postoperative patients of obstructive jaundice. Meth- ods： 26 obstructive jaundice patients （15 male, 11 female）were randomly divided into EN group, EN ＋ radix astragali group（EN ＋ H group）and EEN ＋ radix astragali group（EEN ＋ H group） after the opera- tion of obstructive jaundice. Results ： The nutrition index and lymphocyte （LYM） of patients in the postoperative ld were lower than those before operation（P 〈 0.05）. In the postoperative 7 d, the levels of serum ALB, PA and IgG of EEN ＋ H group were higher than those of EN ＋ H group （P 〈 0.05 ）. And the duration of ventilation, length of stay in hospital, total cost of hospitalization and cost of nutritional support of EEN ＋ H group were lower than those of EN ＋ H group （P 〈 0.05）. Conclusion ： EEN en- haneed by Radix astragali can restore effectively the nutritional,immunal and hepatic conditions in postoperative patients with obstructive jaundice, decrease the incidence of infection,enhance gut function, re- duce length of stay in hospital and save cost of hospitalization.