术前口服葡萄糖溶液对胸部食管癌术后免疫和代谢的影响

Clinical effect of oral glucose on immunity and metabolism in the treatment of chest esophageal cancer operation

目的:探讨术前口服葡萄糖溶液对行胸部食管癌术患者的免疫及代谢的影响。方法:将2011年1月至2016年5月陕西省渭南市中心医院收治的82例行胸部食管癌术的患者随机分成对照组和观察组,每组41例。对照组采用传统禁食禁水方法,即麻醉诱导前12h禁食、6h禁水,观察组采用术前口服葡萄糖溶液,即麻醉前12h禁食禁水,麻醉前2h口服葡萄糖溶液300mL。对比两组的免疫功能及代谢情况。结果:术后第1天和第3天,观察组患者的CD4+、CD4+/CD_8^+比值、白蛋白、前白蛋白明显高于对照组(均P<0.01),术后第7天,两组的CD4+、CD4+/CD_8^+比值、白蛋白、前白蛋白与术前比较差异无统计学意义(均P>0.05);两组术后的IgG、IgM、IgA较术前均有明显降低,随时间的延长而逐渐恢复,观察组术后第7天的IgG、IgM、IgA值显著高于对照组(均P<0.01);两组患者均未出现误吸情况。结论:术前口服葡萄糖溶液可以有效提高患者的免疫功能,改善代谢状态,对于胸部食管癌术后恢复具有重要意义。

Objective：To explore the clinical value of oral glucose on immunity and metabolism in the treatment of chest esophageal cancer operation. Methods： 82 hospitalized esophageal cancer who received chest operation from January 2011 to May 2016 in our hospital were selected and divided into two groups. Patients in control group were treated with traditional with holding food and water methods, they were with holded food and water 12 h and 8 h before anesthesia induction, respectively. Simultaneously, those in experimental group were treated with oral glucose, they were with holded food and water 12 h before anesthesia induction, and received oral glucose 2 h before ansthesia induction. Compare the immunity function and metabolism status of these two groups. Results： At the time of 1 day and 3 days after operation, the CD4^＋ , CD4^/ CD8^＋ ratio, alhumin and prealbumin were significantly higher than that of control group （ P 〈0.01）. At the time of 1 day and 3 days after operation, the CD4^ ＋ , CD4 ^＋/CD8 ^＋ ratio, albumin and prealbumin of the two groups had no statistical differences compared with pre-operation （ P 〉0.05）. Conclusion： Oral glucose at the time of 2 h before ansthesia induction could enhance immunity function and improve metabolism status, and thus is of important significance in ensuring the success of the chest esophageal cancer operation.