营养支持对胃肠道肿瘤患者术后营养状况及恢复的作用

Role of nutritional support to nutritional status and recovery in gastrointestinal cancer patients after surgery

目的探讨营养支持疗法在胃肠道肿瘤患者术后营养状况及恢复中的作用。方法选择2012年7月至2013年7月间收治的176例胃肠道肿瘤术后患者,采用随机数字表法分为观察组和对照组,每组88例。观察组患者给予早期肠内营养(EN)支持干预治疗措施,对照组患者给予肠外营养(PN)支持干预治疗措施,对治疗1周后两组患者的体重、白蛋白、淋巴细胞总数及其亚群构成等情况进行对比分析。结果观察组患者术后住院时间、肠道恢复时间、排气时间及腹部不良发生情况均明显优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者体重、白蛋白、前白蛋白含量水平、淋巴细胞总数、CD3+、CD4+及CD8+T细胞水平均明显高于对照组,差异有统计学意义(P<0.05)。结论对于胃肠道肿瘤术后患者,应用两种治疗方式均有疗效,早期肠道营养的干预治疗措施不仅能更明显改善患者的临床营养状态,提高肠道功能,而且还能增强患者免疫力,降低不良反应的发生率,故更加有利于患者的恢复,值得在临床中应用。

Objective To investigate the role of nutritional support to nutritional status and recov- ery in gastrointestinal cancer patients after surgery. Methods Between July 2012 and July 2013 in Sichuan Provincial Tumor Hospital, 176 gastrointestinal cancer patients after surgery were selected, and they were randomly divided into the observation group and the control group according to random number table, with 88 cases in each group. The patients in the observation group accepted early enteral nutrition （EN） support interventions, and the patients in the control group accepted parenteral nutrition （PN） support interven- tions. Then one week after treatment, the weight, albumin, total lymphocyte count and subsets constitute of two groups were compared. Results The postoperative hospital stay, intestinal recovery time, exhaust time and abdomen incidence of adverse circumstances of the observation group were significantly better than those of the control group, with significant difference （ P 〈 0. 05 ） ; After treatment, the average weight, albumin, prealbumin concentration levels, total lymphocyte count, CD3 ＋ , CD4 ＋ and CD8 ＋ , and other indicators of the observation group were significantly higher than those of the control group, with significant difference （ P 〈 0.05 ）. Conclusions For gastrointestinal tumor surgery cancer patients, both treatments were effec- tive. The early enteral nutrition intervention measures can not only significantly improve clinical nutritional status and bowel function, but also enhance the patient immunity, and reduce the incidence of adverse reac- tions. So it is more beneficial to the oatient＇s recovery and is worthy to be used clinically.