膳食纤维肠内营养制剂对结直肠癌患者术后肠道屏障应激及营养指标的影响

Effect of dietary fiber enteral nutrition preparation on postoperative intestinal barrier stress and nutritional index in patients with colorectal cancer

目的:观察膳食纤维肠内营养制剂对CRC患者术后肠道屏障功能、炎症应激反应以及肠道动力功能恢复的影响,并对术后患者的营养状态进行评价。方法:选取65名结直肠癌患者,术后随机分为含膳食纤维组(DF组)与非膳食纤维组(NDF组)。对两组患者肠道屏障功能指标血D-乳酸与DAO值;炎性因子指标WBC、CRP、IL-6、TNF-α和PTC水平;营养指标ALB、PA、TRF水平以及术后不良反应及并发症进行比较分析。结果:两组患者术后DAO水平与术前比较均显著下降,术后NDF组D-乳酸水平均与术前相比无统计学差异,但有降低趋势;术后DF组D-乳酸与DAO水平均低于NDF组,差异有统计学意义(P<0.05)。除NDF组WBC和CRP外,患者术后炎症因子水平与术前比较均降低;与NDF组相比,DF组术后炎症因子WBC、CRP、IL-6、TNF-α和PTC水平显著降低,差异有统计学意义(P<0.05)。除NDF组TRF因子外,患者术后营养指标水平与术前比较均显著升高;术后DF组与NDF组营养指标水平比较无统计学差异,但有升高的趋势。术后排气、便时间比较,DF组显著低于NDF组,有统计学差异(P<0.05),创口感染、恶心呕吐和死亡指标比较无统计学差异(P>0.05)。结论:结直肠癌患者术后早期给予含膳食纤维肠内营养制剂治疗,能显著改善患者肠道屏障功能、恢复胃肠动力,抑制肠道内炎症应激反应,改善患者术后状况。

Objective: To observe the effect of dietary fiber enteral nutrition on postoperative intestinal barrier function, inflammatory stress response and intestinal dynamic recovery of CRC patients, and to evaluate the nutritional status of postoperative patients. Methods: Sixty-five patients with colorectal cancer were randomly divided into 2 groups: dietary fiber (DF group) and non-dietary fiber (NDF group). Blood D-lactic acid and DAO values of intestinal barrier function indexes in two groups of patients;Inflammatory factor index the WBC, CRP, IL-6, TNF-α and PTC level;ALB, PA, TRF levels, postoperative adverse reactions and complications were compared and analyzed. Results: The postoperative DAO level of patients in both groups decreased significantly compared with that before surgery, and the postoperative D-lactic acid level of patients in the NDF group showed no statistical difference compared with that postsurgical results, but there was a decreasing trend. The levels of D-lactic acid and DAO in postoperative DF group were lower than those in NDF group, and the difference was statistically significant (P<0.05). In addition to WBC and CRP in the NDF group, the postoperative inflammatory factors were decreased compared with those before surgery. Compared with the NDF group, postoperative inflammatory factor the WBC DF group, CRP, IL-6, TNF-α and PTC were significantly reduced, and the difference was statistically significant (P<0.05). In addition to the TRF factor in the NDF group, the postoperative nutrition index level of the patients increased significantly compared with the preoperative level. Postoperative DF group and NDF group showed no significant difference in nutritional indicators, but there was an upward trend. Compared with postoperative exhaustion and defecation time, the DF group was significantly lower than the NDF group (P<0.05), and there was no statistically significant difference in wound infection, nausea, vomiting and mortality (P>0.05). Conclusion: early postoperative enteral nutrition preparations containing dietary fiber can significantly improve the intestinal barrier function and restore gastrointestinal dynamics. It could also inhibit intestinal inflammatory stress reaction and improve postsurgical conditions.