术前肠内麦芽糊精果糖液联合肠外营养对术后营养状态、外周血T细胞亚群及恢复情况的影响

Effects of enteral maltodextrin combined with parenteral nutrition before operation on postoperative nutritional status and peripheral blood T cell subsets in patients after operation

目的探讨术前肠内麦芽糊精果糖液联合肠外营养对手术患者术后营养状态、外周血T细胞亚群以及术后恢复情况的影响。方法行胃癌、结直肠癌手术患者90例,随机分为对照组和观察组,每组45例。对照组在术后进行普通肠外营养,观察组在对照组基础上术前2 h给予肠内麦芽糊精果糖液。比较2组患者营养状态、外周血T细胞亚群、炎症水平、术后恢复情况及并发症发生情况。结果术前研究组白蛋白(ALB)、前白蛋白(PA)水平差异无统计学意义(P>0.05),术后均显下降(P<0.05),其中研究组ALB、PAB水平均显著高于对照组(P<0.05)。术后2组外周血T细胞亚群有不同程度的变化,其中研究组的CD+3、CD+4、CD+8以及CD+4/CD+8显著高于对照组(P<0.05)。术前2组患者炎症水平差异无统计学意义(P>0.05),术后均显著升高(P<0.05),研究组C-反应蛋白(CRP)以及白介素-6(IL-6)水平均显著低于对照组(P<0.05)。研究组排气时间、下床时间、住院时间、院内感染及术后寒战发生率显著低于对照组(P<0.05)。结论术前肠内麦芽糊精果糖液联合肠外营养可更好的改善手术患者术后营养状态、并提高机体的免疫力,有助于促进患者术后恢复和减少并发症的发生。

Objective To investigate the effects of enteral maltodextrin combined with parenteral nutrition before operation on postoperative nutritional status and peripheral blood T cell subsets in patients after operation.Methods Ninety patients with gastric cancer and colorectal cancer who underwent surgical treatment in our hospital from March 2016 to March 2018 were randomly divided into control group and observation grou,with 45 patients in each group.The patients in control group were given common parenteral nutrition after operation,however,the patients in observation group,on the basis of control group,were given enteral maltodextrin at 2h before operation.The nutritional status,peripheral blood T cell subsets,inflammation levels,postoperative recovery and complications were observed and compared between the two groups.Results Before operation there were no significant differences in the levels of ALB and PA between the two groups(P>0.05).After operation the levels of ALB and PAB were decreased significantly in both groups(P<0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05).After operation there were significant differences in peripheral blood T cell subsets in both groups,and the levels of CD3+,CD4+,CD8+and CD4+/CD8+in observation group were significantly higher than those in control group(P<0.05).Before operation there were no significant differences in the levels of inflammatory factors between the two groups(P>0.05).After operation the levels of inflammatory factors were significantly increased in both groups(P<0.05),moreover,the levels of CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05).In addition the exhaust time,getting out of bed time,hospitalization time and the incidence of nosocomial infection in observation group were significantly lower than those in control group(P<0.05).Conclusion The intraintestinal maltodextrin combined with parenteral nutrition before surgery can improve the postoperative nutritional status of patients,and improve the body’s immunity,which is helpful to promote postoperative recovery and reduce the incidence of complications.