不同静脉途径输注肠外营养对胃癌术后患者的营养状况及免疫功能影响的研究

Effect of parenteral nutrition through different intravenous infusion ways on nutritional status and immune function of patients received gastric cancer operation

目的探讨胃癌术后患者给予不同静脉途径输注肠外营养对其营养状况及免疫功能的影响作用。方法选择2019年7月—2020年7月本院收治的120例胃癌患者作为研究对象,随机数表法分为A、B、C共三组,每组各40例。A组采取经外周静脉(PVC)输注肠外营养,B组采取经外周静脉置入中心静脉导管(PICC)输注肠外营养,C组采取经中心静脉导管(CVC)输注肠外营养,比较各组术前、术后3天、术后7天的淋巴细胞总数(LYM)、IgA、IgG、IgM、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、血红蛋白(HGB)、白蛋白(ALB)、总蛋白(TP)、前蛋白(PA)、转铁蛋白(TRF)指标,并对其进行分析。结果与术前比较,三组术后3天、7天的ALB、TP、PA、HGB、TRF营养学指标水平比较差异有统计学意义(P<0.05),各时间点三组间ALB、TP、PA、HGB、TRF营养学指标水平比较差异无统计学意义(P>0.05);与术前比较,三组术后3天、术后7天LYM、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IgA、IgG、IgM各项免疫功能指标比较差异有统计学意义(P<0.05),各时间点三组间LYM、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IgA、IgG、IgM指标比较差异无统计学意义(P>0.05);B组不良反应发生率为10.00%,明显低于A组的30.00%、C组的25.00%(P<0.05)。结论胃癌患者术后通过PVC、PICC、CVC输注肠外营养均可改善其营养状态及免疫功能,但PICC不良反应发生少,更有利于患者术后恢复。

Objective To investigate the effect of parenteral nutrition through different intravenous infusion ways on nutritional status and immune function of patients after gastric cancer operation.Methods A total of 120 gastric cancer patients admitted to the hospital from July 2019 to July 2020 were selected as the study subjects.Using random number table method,the patients were divided into group A,group B,and group C,with 40 cases in each group.Group A received parenteral nutrition via peripheral venous catheter(PVC),group B received parenteral nutrition via peripherally inserted central catheter(PICC),and group C received parenteral nutrition via central venous catheter(CVC).The total lymphocyte count(LYM),IgA,IgG,IgM,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),hemoglobin(HGB),albumin(ALB),total protein(TP),prealbumin(PA),and transferrin(TRF)were compared between the groups before operation,at 3 daysand 7 days after operation.Results Compared with those before operation,thelevels of ALB,TP,PA,HGB,and TRF in the three groups showed statistically significant differences at 3 and 7 days after operation(P<0.05),but no statistically significant differences were found among the three groups at each time point(P>0.05).Compared with those before operation,LYM,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IgA,IgG,and IgM showed statistically significant differences at 3 and 7 days after operation(P<0.05),but no statistically significant differences were found among the three groups at each time point(P>0.05).The incidence of adverse reactions in group B was 10.00%,which was significantly lower than that in group A(30.00%)and that in group C(25.00%)(P<0.05).Conclusions Postoperative parenteral nutrition through PVC,PICC and CVC all could improve the nutritional status and immune function of patients with gastric cancer,what’s more PICC has fewer adverse reactions and is more conducive to postoperative recovery.