围手术期增强免疫型肠内营养对限期手术老年结直肠癌患者支持后营养状态、炎症反应、胃肠功能及预后的影响

Effect of perioperative enhanced immune type enteral nutrition on nutritional status,inflammatory reaction,gastrointestinal function and prognosis in elderly patients with elective colorectal cancer after support

目的探讨围手术期增强免疫型肠内营养对限期手术老年结直肠癌患者支持后营养状态、炎症反应、胃肠功能及预后影响。方法选取医院限期手术老年结直肠癌患者70例作为研究对象,随机将患者分为对照组和观察组各35例,对照组给予围手术期常规肠内营养支持,观察组给予围手术期增强免疫型肠内营养支持,观察支持前和支持后7d营养状态、机体炎性反应机及胃肠道功能恢复情况,对比两组临床结局。结果观察组支持后7d TP、PA、ALB、TF、L/M分别为(73.05±3.51)g/L、(316.42±9.40)mg/L、(41.27±2.97)g/L、(2.80±0.34)g/L、(0.04±0.02)均显著高于对照组,具有统计学意义(P<0.05);观察组支持后CD3、CD4、CD4/CD8、lg A、lg M分别为(74.69±6.78)%、(46.62±5.07)%、(1.71±0.46)、(3.85±1.57)g/L、(1.20±0.38)g/L均显著高于对照组,具有统计学意义(P<0.05);观察组支持后CRP、IL-6、TNF-α分别为(6.68±0.46)mg/L、(407.64±43.29)ng/L、(109.67±12.6)ng/L均显著低于对照组,具有统计学意义(P<0.05);观察组肠道通气时间和住院时间分别为(2.06±0.41)d、(7.47±1.69)d显著短于对照组,具有统计学意义(P<0.05)。结论围手术期增强免疫型肠内营养支持能够改善老年结直肠癌限期手术患者的营养状态,降低机体炎性反应。

Objective To investigate the effect of perioperative enhanced immune type enteral nutrition on nutritional status,inflammatory reaction,gastrointestinal function and prognosis in elderly patients with elective colorectal cancer after support.Methods 70 cases of elderly patients with elective colorectal cancer were selected as the research objects.According to the random number table method,the patients were divided into the control group and 30 cases in the observation group.The control group received perioperative routine enteral nutrition support,and the observation group received perioperative enhanced immune type enteral nutrition support.The nutritional status,inflammatory reactions of the body and the recovery of gastrointestinal function in 7d before and after support were observed and the clinical outcomes of the 2 groups were compared.Results 7days after support,TP,PA,ALB,TF,and L/M of the observation group were(73.05±3.51)g/L,(316.42±9.40)mg/L,(41.27±2.97)g/L,(2.80±0.34)g/L and(0.04±0.02),respectively which were significantly higher than those of the control group(P <0.05);After support,CD3,CD4,CD4/CD8,lg A and lg M of the observation group were(74.69 ±6.78)%,(46.62±5.07)%,(1.71±0.46),(3.85±1.57)g/L and(1.20±0.38)g/L,respectively which were significantly higher than those of the control group(P <0.05).After support,CRP,IL-6 and TNF-αwere(6.68±0.46)mg/L,(407.64±43.29)ng/L and(109.67±12.6)ng/L,respectively which were significantly lower than those of the control group(P <0.05);The time of intestinal ventilation(2.06±0.41)d and length of hospital stays(7.47±1.69)d of the observation group was significantly shorter than that of the control group(P <0.05).Conclusion Perioperative enhanced immune type enteral nutrition support can improve the nutritional status of elderly patients undergoing elective colorectal cancer operation and reduce the inflammatory ractions in body.