早期营养支持对口腔恶性肿瘤患者术后康复的影响

Effect of early nutrition support on the postoperative rehabilitation in patients with oral cancer

目的:观察早期营养支持对口腔恶性肿瘤患者术后营养代谢及康复的影响。方法:选取于我院手术治疗的口腔恶性肿瘤患者80例进行观察,术后行早期营养支持治疗的患者40例设为观察组,术后行常规处置的40例患者设为对照组,观察组术后基础营养需要量依据Harris-Nenedict公式计算,并为该组患者选择适宜的制剂及营养途径;对照组术后常规膳食处置。对比两组术前、术后血清白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TRF)、总淋巴细胞计数(TLC)及外周血免疫球蛋白(IgM、IgG、IgA)水平变化,并对患者体质量、伤口愈合情况进行记录、对比。结果:观察组术后体质量及血清TRF较术前略有下降,但与术前比较,差异无统计学意义(P>0.05);观察组术后血清ALB、PAB及TLC明显低于术前(P<0.05);对照组术后体质量、血清ALB、PAB、TRF、TLC均明显低于术前(P<0.05);两组术前外周血IgM、IgG、IgA水平比较,差异无统计学意义(P>0.05),治疗后上述指标明显升高(P<0.05);观察组术后一周外周血IgM、IgG、IgA水平明显高于对照组(P<0.05);观察组手术创口I期愈合率明显高于对照组(P<0.05)。结论:早期营养支持能有效提高口腔恶性肿瘤患者术后营养状况及免疫功能,利于患者术后康复。

Objective：To explore the effects of early nutrition support on the postoperative nutrition metabolism and re-habilitation in patients with oral cancer.Methods：A total of 80 patients with oral cancer who were admitted in our hospital were included in the study,and divided into the observation group （early nutrition support）and control group （routine treat-ments）with 40 cases in each group.The postoperative basic nutrition requirement amount in the observation group was calcu-lated according to Harris-Nenedict formula.The appropriate pharmaceutics and nutritional pathway were selected.The patients in the control group were given routine diets after operation.The levels of ALB,PAB,TRF,TCL,IgM,IgG,and IgA before and after operation in the two groups were compared.The body mass and wound healing in the two groups were recorded andnbsp;compared.Results：The body mass and serum TRF level after operation in the observation group were slightly reduced,but were not significantly different from those before operation （P 〉0.05）.The serum ALB,PAB,and TLC levels after operation in the observation group were significantly reduced when compared with before operation （P 〈0.05）.The body mass,and ser-um ALB,PAB,TRF,and TLC levels after operation in the control group were significantly reduced when compared with be-fore operation （P 〈0.05 ）.The comparison of peripheral blood IgM,IgG,and IgA levels before operation between the two groups was not statistically significant （P 〉0.05 ）,but the above indicators were significantly elevated after operation （P 〈0.05）.The peripheral blood IgM,IgG,and IgA levels 1 week after operation in the observation group were significantly higher than those in the control group （P 〈0.05）.The stage I healing rate of the surgical wound in the observation group was signifi-cantly higher than that in the control group （P 〈0.05 ）.Conclusions：The early nutrition support can effectively enhance the postoperative nutrition status and immunological function in patients with oral cancer,and is beneficial for the postoperative re-habilitation.