早期肠内营养支持对肝胆胰恶性肿瘤术后化疗患者营养状况、免疫功能及预后的影响

Effects of early enteral nutrition support on nutritional status,immune function and prognosis of patients with hepatobiliary and pancreatic malignant tumors undergoing postoperative chemotherapy

目的探讨早期肠内营养支持在肝胆胰恶性肿瘤术后化疗患者中的临床应用意义。方法选取2015年6月至2017年6月期间所收治的96例肝胆胰恶性肿瘤术后化疗患者作为临床研究对象,采用随机数字表法将患者随机分为干预组49例和对照组47例。干预组患者采用早期肠内营养支持方案,对照组患者则采用肠外营养支持方案,并分别对两组肝胆胰恶性肿瘤患者营养状况、细胞免疫功能、体液免疫功能、并发症发生情况进行比较和分析。结果与对照组相比,干预组治疗后血清前白蛋白(PA)、白蛋白(ALB)、转铁蛋白(TF)、总蛋白(TP)、体重(BW)、T细胞亚群(CD3+、CD4+、CD4+/CD8+)及免疫球蛋白(Ig A、Ig G、Ig M)的水平均明显提高,差异均具有统计学意义(P均<0. 01);与对照组患者相比,干预组患者感染发生率(30. 61%vs 51. 06%)和腹胀腹泻发生率(71. 43%vs 91. 49%)均明显降低,差异均具有统计学意义(P均<0. 05)。结论早期肠内营养支持可以改善肝胆胰恶性肿瘤术后化疗患者的营养状况,提高患者的免疫功能,有效降低相关并发症的发生,从而利于患者预后的改善,加速患者康复。

Objective To probe into the clinical application value of early enteral nutrition support on postoperative chemotherapy in patients with hepatobiliary and pancreatic malignant tumor. Methods A total of 96 patients with hepatobiliary and pancreatic malignant tumor receiving postoperative chemotherapy from June 2015 to June 2017 were selected as research subjects. The patients were divided into intervention group( n = 49) and control group( n = 47) by random number table method. The early enteral nutrition support was performed in intervention group,while the parenteral nutrition support was performed in control group. The nutritional status,cellular immune function,humoral immune function and complications of patients were compared and analyzed between two groups. Results Compared with control group,the serum levels of prealbumin( PA),albumin( ALB),transferrin( TF),total serum protein( TP),body weight,levels of CD3^+、CD4^+、CD4^+/CD8^+,levels of immunoglobulin( Ig A,Ig G and Ig M) in intervention group significantly increased after treatment( all P < 0. 01). The incidences of infection( 30. 61% vs 51. 06%) and abdominal distension and diarrhea( 71. 43% vs 91. 49%) in intervention group significantly decreased compared with control group( all P < 0. 05).Conclusion Early enteral nutrition support can effectively improve the nutritional status and the immune function,reduce the occurrence of related complications of postoperative chemotherapy in patients with hepatobiliary and pancreatic malignant tumor,thus it is conducive to the prognosis and the recovery of patients.