低热量肠内营养与肠外营养在原发性肝癌患者术后治疗中的应用效果

THE CLINIC EFFECT OF HYPOCALORIC PARENTERAL NUTRTION AND HYPOCALORIC ENTERAL NUTRITION FOR PATIENTS WITH PRIMARY LIVER CANCER

目的:分析低热量肠外营养(HPN)与低热量肠内营养(HEN)在原发性肝癌术后患者治疗中的应用效果。方法:收集2011年3月至2015年12月中航工业363医院收治确诊的原发性肝癌术后患者118例,按随机数字表法将其分成观察组与对照组,每组59例。观察组以低热量HEN,对照组则施以低热量HPN,记录并比较两组患者干预前、后谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)、直接胆红素(DBIL)等肝功能指标;假性胆碱酯酶(PCHE)、白蛋白(ALB)、前白蛋白(PA)等营养指标;CD8^+、CD4^+及CD4^+/CD8^+、IgM、IgG、IgA等免疫功能指标。结果:两组干预前ALT、TBIL、AST、TBIL、PCHE、ALB、PA、CD8^+、CD4^+、CD4^+/CD8^+、IgM、IgG、IgA值比较,差异无统计学意义(均P>0.05);观察组干预后ALT、TBIL、AST、DBIL、PCHE、ALB、PA、CD8^+、CD4^+、CD4^+/CD8^+、IgM、IgG、IgA值均明显优于对照组(均P<0.05);两组干预后ALT、TBIL、AST、DBIL、PCHE、ALB、PA、CD8^+、CD4^+、CD4^+/CD8^+、IgM、IgG、IgA值与组内干预前比较差异均有统计学意义(均P<0.05)。结论:低热量HEN较低热量HPN能更有效地改善原发性肝癌患者术后肝功能及营养、免疫功能指标,疗效显著,具有重要的临床应用价值。

Objective：To study the clinic effect of hypocaloric parenteral nutrition（HPN）and hypocaloric enteral nutrition（HEN）which used in the treatment of patients with primary liver cancer.Methods：118cases of primary liver cancer patients treated in our hospital from March 2011 to December 2015 were divided into the control group and the observation group,according to random number table method.59 cases in each group.The control group was administered with HEN and the observation group were treated by HPN,followed by the comparison of immune and liver function between patients of two groups.Results：Before intervention,there were no significant differences of ALT,TBiL,AST,DBi,PCHE,ALB,PA,CD8^＋,CD4^＋,CD4^＋/CD8^＋,IgA,IgM and IgG value between the observation group and the control group（P〈0.05）.After intervention,values of ALT,TBiL,AST,DBi,PCHE,ALB,PA,CD8^＋,CD4^＋,CD4^＋/CD8^＋,IgA,IgM and IgG were significantly improved in the observation group,compared to those in the control group（P〈0.05）.Conclusion：HEN is more effective than HPN in improving immune and liver function of primary liver cancer patients.