摘要
目的比较早期肠外营养与肠内营养对全胃切除术患者营养、免疫及肝功能状态的影响。方法选取90例全胃切除术患者为研究对象,将所有患者分为A组(早期肠外营养组)和B组(早期肠内营养组)各45例,比较两组患者干预前与干预后3、10d的营养状态相关指标、免疫功能指标及肝功能指标。结果B组干预后3、10d的营养状态相关指标[3d:总蛋白(TP)(68.35±3.02)g/L、清蛋白(A)(38.94±4.69)g/l,、前清蛋白(PAB)(273.54±29.68)mg/L、转铁蛋白(TRF)(2.14±0.29)g/L、血红蛋白(Hb)(129.84±7.92)g/L;10d:总蛋白(72.59±3.52)g/L、清蛋白(42.31±5.49)g/L、前清蛋白(305.57±30.95)mg/L、转铁蛋白(2.78±0.31)g/L、血红蛋白(135.87±8.95)g/L]、免疫功能指标[3d:免疫球蛋白A(IgA)(0.94±O.10)g/L、免疫球蛋白G(IgG)(9.24±0.63)g/L、免疫球蛋白M(IgM)(1.51±0.14)g/L、红细胞补体C3b受体(RBC—C3bR)(10.54±0.52)%、红细胞免疫复合物花环率(RBC—ICR)(12.21±1.41)%;10d:IgA(1.23±0.15)g/L、IgG(10.98±0.72)g/L、IgM(1.71±0.18)g/L、RBC—C3bR(13.74±0.69)%、RBC-ICR(9.27±1.05)%]及肝功能指标[3d:谷丙转氨酶(ALT)(32.59±3.56)U/L、谷草转氨酶(AsT)(33.95±4.03)U/L、总胆红素(TBIL)(12.07±1.38)μmol/L、谷酰转肽酶(GGT)(24.03±2.59)U/L;10d:ALT(22.93±3.18)U/L、AST(24.84±3.29)U/L、TBIL(10.50±0.96)μmol/L、GGT(20.70±2.49)U/L]均明显优于A组[3d:总蛋白(64.59±2.83)g/L、清蛋白(35.53±4.37)g/L、前清蛋白(224.96±25.50)mg/L、转铁蛋白(1.63±0.20)g/L、血红蛋白(121.03±7.18)g/L、IgA(0.68±0.07)g/L、IgG(7.32±0.51)g/L、IgM(1.12±0.10)g/L、RBC—C3bR(8.13±0.40)%、RBC—ICR(14.59±1.54)%、ALT(40.26±4.13)U/L、AST(40.95±4.26)U/L、TBIL(16.37±1.75)ixmol/L、GGT(31.4±2.97)U/L;10d:总蛋白(66.96±2.97)g/L、清蛋白(36.01±4.43)g/L、前清蛋白(241.35±26.63)mg/L、转铁蛋白(1.86±0.24)g/L、血红蛋白(127.69±7.73)g/L、IgA(0.81±0.08)g/L、IgG(8.54±0.55)g/L、IgM(1.28±0.12)g/L、RBC—C3bR(8.52±0.46)%、RBC-ICR(13.07±1.46)%、ALT(31.52±3.84)U/L、AST(33.54±3.90)U/L、TBIL(13.21±1.41)μmol/L、GGT(25.39±2.65)U/L],且B组上述指标干预后10d优于干预后3d,差异均有统计学意义(P〈0.05)。结论早期肠内营养对全胃切除术患者的营养、免疫及肝功能状态的改善均发挥着积极的作用,为患者的术后康复提供了必要的前提。
Objective To compare the influence of early parenteral nutrition and enteral nutrition on the nutrition, immune, and liver function state of patients with total gastrectomy. Methods A total of 90 patients with total gastrectomy in our hospital from July 2010 to October 2012 were selected as research ob- jects, and were randomly divided into group A (early parenteral nutrition group, n = 45 )and group B (early enteral nutrition group, n = 45). The nutrition state indexes, immune state indexes, and liver function in- dexes of two groups before the intervention and at 3th and 10th day after the intervention were compared.Results The nutrition state indexes[3rd d:TP (68.35±3.02)g/L, A (38.94±4.69)g/L, PAB (273.54 ±29. 68) mg/L, TRF (2. 14 ±0. 29) g/L, Hb (129. 84 ±7.92)g/L;10th d:TP (72. 59 ±3.52) g/L, A (42.31 ±5.49)g/L, PAB (305.57 ±30.95)mg/L, TRF (2.78 ±0.31)g/L, Hb (135.87 ± 8. 95)g/L] ,immune state indexes[3rd d:IgA (0. 94 ±0.10)g/L, IgG (9. 24 s0. 63)g/L, IgM (1.51 ± 0. 14) g/L, RBC-C3bR ( 10. 54 ± 0. 52) %, RBC-ICR ( 12. 21 ± 1.41 ) % ; 10th d:IgA ( 1.23 s0. 15) g/L, IgG (10.98 ±0.72)g/L, IgM (1.71 ±0. 18)g/L, RBC-C3bR (13.74 ±0.69)%, RBC-ICR (9.27 ± 1.05)% ], and liver function indexes[3rd d:ALT (32.59 ±3.56) U/L, AST (33.95 ±4.03) U/L, TBIL (12.07 ± 1.38)lxmol/L, GGT (24.03 ±2.59)U/L;10th d:ALT (22.93 ±3.18)U/L, AST (24.84 ± 3.29) U/L, TBIL ( 10. 50 ±0.96) μmol/L, GGT (20.70 ± 2. 49) U/L] in group B at 3rd and 10th day af- ter the interventiont were all better than those in group A [ 3rd d : TP (64. 59 ± 2. 83 ) g/L, A ( 35.53 ± 4. 37) g/L, PAB (224.96 ±25. 50)mg/L, TRF(1.63 s0. 20)g/L, Hb (121.03 ±7.18) g/L, IgA (0.68 ± 0.07 ) g/L, IgG (7.32 ± 0. 51 ) g/L, IgM ( 1.12 ± 0. 10) g/L, RBC-C3bR (8. 13 ± 0. 40) %, RBC-ICR (14.59 ±1.54)%, ALT (40.26 ±4. 13)U/L, AST (40.95 ±4.26) U/L, TBIL (16.37 ± 1.75) I±mol/ L, GGT ( 31.45 ± 2. 97) U/L; 10th d: TP (66. 96 ± 2.97 ) g/L, A ( 36. 01 ± 4. 43 ) g/L, PAB ( 241.35 ± 26. 63 ) mg/L, TRF ( 1.86 ± 0. 24) g/L, nb( 127. 69 ± 7.73 ) g/L, IgA (0. 81 ± 0. 08) g/L, IgG (8. 54 ± 0. 55) g/L, IgM ( 1.28 ± 0. 12) g/L, RBC-C3bR ( 8.52 ± 0. 46) %, RBC-ICR ( 13.07 ± 1.46) %, ALT (31.52 ± 3.84) U/L, AST (33.54 ± 3.90) U/L, TBIL ( 13.21 ± 1.41 ) μmol/L, GGT (25.39 ±2.65) U/ L] ,and these indexes in group B at 10th day after the intervention were all significantly better than those at 3rd day after the intervention ( all P 〈 0. 05). Conclusions The early enteral nutrition palys an active role in improving the nutrition, immune, and liver function state of patients with total gastrectomy, and it provides the necessary premise for the postoperative rehabilitation of patients.
出处
《中国医师杂志》
CAS
2013年第4期475-478,共4页
Journal of Chinese Physician
关键词
肠道营养
胃肠外营养
胃切除术
营养状况
免疫
Enteral nutrition
Parenteral nutrition
Gastrectomy
Nutritional status
Immunity Enteral nutrition
Parenteral nutrition
Gastrectomy
Nutritional status
Immunity