肠外联合肠内营养对恶性梗阻性黄疸PTCD术后肝功能指标的影响

Effect of parenteral combined with enteral nutrition support therapy on liver function of malignant obstructive jaundice after percutaneous transhepatic cholangial drainage

目的探讨肠外联合肠内营养支持治疗对恶性梗阻性黄疸患者经皮肝穿刺胆管引流术(PTCD)术后肝功能指标的影响。方法将2015年6月~2016年6月华北理工大学附属医院收治的100例均进行PTCD的恶性梗阻性黄疸患者,按照随机数字表法分为两组。对照组患者给予肠外营养支持治疗,观察组患者给予肠外联合肠内营养支持治疗。比较两组患者治疗前后谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)、胆汁酸(TBA)、CD4^+、CD8^+、CD4^+/CD8^+、IgA、IgG和IgM水平。结果治疗后,观察组患者ALT、AST、ALP和GGT水平较对照组明显降低(P<0.05)。治疗后,观察组患者TBIL、DBIL和TBA水平较对照组明显降低(P<0.05)。治疗后,观察组患者CD4^+、CD8^+和CD4^+/CD8^+较对照组明显升高(P<0.05)。治疗后,观察组患者IgA、IgG和IgM水平均较对照组明显升高(P<0.05)。结论肠外联合肠内营养支持治疗可明显改善恶性梗阻性黄疸患者PTCD术后肝功能,提高免疫功能。

Objective To explore effect of parenteral combined with enteral nutrition support therapy on liver function of malignant obstructive jaundice after percutaneous transhepatic choiangial drainage （PTCD）. Methods 100 patients with malignant obstructive jaundice after PTCD in North China University of Technology Affiliated Hospital from June 2015 to June 2016 were divided into two groups by using the random number table method. Control group was given parenteral nutrition support therapy, while observation group was given parenteral combined with enteral nutrition support therapy. The levels of ALT, AST, ALP, GGT, TBIL, DBIL, TBA, CD4＋, CD8~, CD4＋/CD8＋, IgA, IgG and IgM between two groups before and after treatment were compared. Results The levels of ALT, AST, ALP and GGT in observation group after treatment were significantly lower than those in control group （P 〈 0.05）. The levels of TBIL, DBIL and TBA in observation group after treatment were significantly lower than those in control group （P 〈 0.05）. CD4＋, CD8＋ and CD4＋/CD8＋ in observation group after treatment were significantly higher than those in control group （P 〈 0.05）. IgA, IgG and IgM in observation group after treatment were significantly higher than those in control group （P 〈 0.05）. Conclusion Parenteral combined with enteral nutrition support therapy can effectively improve liver function of patients with malignant obstructive jaundice after PTCD, and enhance immune function.