全肠外营养对老年大肠癌病人术后的治疗作用(附42例临床分析)

The effects of TPN on postoperative patients with colon or rectum cancer (clinical analysis of 42 cases)

目的 :研究老年大肠癌病人行根治术后进行全肠外营养支持 ,对术后恢复、胃肠道功能恢复、创口愈合及免疫功能的影响。 方法 :对 42例 6 5岁以上的大肠癌病人随机分为实验组 (TPN组 )和对照组 (非 TPN组 )。实验组采用全营养混合液 (TNA)经颈内静脉输注 ,从术后第 1天起每天输注 ,连续 8～ 9天 ,每天提供非蛋白热量 83.7～12 5 .5 k J(2 0～ 30 kcal) /(kg· d) ,氮 0 .12～ 0 .16 g/(kg· d) ,脂肪占总热量约 2 0 %～ 30 % ;对照组术后常规给予葡萄糖与电解质溶液 ,逐步过渡到口服饮食。观察术后胃肠功能的恢复和创口愈合情况 ,检测术前第 1天、术后第 1天及第 8天血清白蛋白、前白蛋白、免疫球蛋白 (Ig G、Ig A、Ig M)及 T细胞亚群的变化。 结果 :实验组胃肠功能恢复时间和创口愈合情况均优于对照组 ,前白蛋白、Ig G与 Ig A水平、CD3+与 CD4+细胞百分率均较对照组显著升高(P<0 .0 1)。 结论 :全肠外营养对术后老年大肠癌病人具有提高机体营养状况、促进胃肠道功能尽早恢复以及创口更好愈合 。

s: Objectives:To study effects of TPN on postoperative patients with colon or rectum cancer,including gut function recovery,wound healing and immune function. Medthods:42 elder patients with colon or rectum cancer were divided into two groups at randomization,TPN group and control group.From POD+1 to POD+8,TPN group was given TNA daily and control group was given solutions of glucose and electrolyte.Gut function recovery and wound healing were observed and albumin,pre albumin,IgG,IgA,IgM,CD3 +,CD4 + and CD8 + were determined on POD+1 and POD+8. Results:The recovery of gut function and wound healing in TPN group were better than those in control group,and levels of pre albumin,IgG,IgA were higher than those in control group. Conclusions:TPN has positive effects in gut function recovery,wound healing and immune function in postoperative patients with colon or rectum cancer.