等差递增肠内营养输注对老年胰腺癌患者营养状况及早期肠内营养喂养耐受性的影响

Effect of Iso-Incremental Enteral Nutrition Infusion on Nutritional Status and Tolerance to Early Enteral Nutrition Feeding in Older Patients with Pancreatic Cancer

目的研究等差递增肠内营养输注对老年胰腺癌患者营养状况及早期肠内营养(EEN)喂养耐受性的影响。方法选取2017年2月~2019年3月收治的胰腺癌术后患者92例作为观察对象,按照抽签法随机分成试验组和对照组各46例。对照组予以常规营养支持,试验组采用等差递增肠内营养输注进行营养支持。两组均进行为期10d的营养支持干预,分别对比两组术前1d、术后10d的营养状态、免疫功能,EEN喂养耐受性情况,术后并发症发生情况。结果术前1d,两组前白蛋白(PA)、白蛋白(ALB)以及转铁蛋白(TRF)水平比较,差异均无统计学意义(P>0.05);术后10d试验组PA、ALB、TRF水平高于对照组,差异均有统计学意义(P<0.05)。试验组总耐受率高于对照组,差异有统计学意义(P<0.05)。术前1d,两组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异均无统计学意义(P>0.05);术后10d,两组CD4^(+)、CD4^(+)/CD8^(+)水平高于术前1d,CD8^(+)水平低于术前1d,差异均有统计学意义(P<0.05);术后10d,试验组CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05)。根据Pearson法分析发现,患者营养状态指标与CD4^(+)及CD4^(+)/CD8^(+)均呈正相关,与CD8^(+)呈负相关(P<0.05)。试验组的切口感染、便秘、腹泻发生率均低于对照组,差异有统计学意义(P<0.05)。结论等差递增肠内营养输注可显著改善老年胰腺癌患者的营养状况,提高EEN喂养耐受性,增强患者免疫功能,降低并发症的发生风险,值得临床推广应用。

Objective To investigate the effect of iso-incremental enteral nutrition infusion on the nutritional status and tolerance to early enteral nutrition(EEN) feeding in older patients with pancreatic cancer.Methods Ninety-two patients undergoing surgery for pancreatic cancer in the First Affiliated Hospital of Harbin Medical University from February 2017 to March 2019 were selected in this study.The patients were randomly divided into the experimental group(46 cases) and the control group(46 cases).The control group was given routine nutritional support, the experimental group was given iso-incremental enteral nutrition infusion for nutritional support.Both groups were given nutritional support for 10 days.The nutritional status, immune function, tolerance to EEN feeding and postoperative complications were compared between the two groups 1 day before and 10 days after surgery.Results One day before surgery, there were no significant differences in the levels of prealbumin(PA),albumin(ALB) and transferrin(TRF) between the two groups(P>0.05).Ten days after surgery, the levels of PA,ALB and TRF in the experimental group were higher than those in the control group(P<0.05).The overall tolerance rate in the experimental group was higher than that in the control group(P<0.05).One day before surgery, there were no significant differences in the percentage of CD4;,CD8;,and CD4;/CD8;between the two groups(P>0.05).Ten days after surgery, the percentage of CD4;,CD4 I+/CD8;were higher than those 1 day before surgery in two groups, while the percentage of CD8;was lower;and the differences were statistically significant(P<0.05).The percentage of CD4;and CD4;/CD8;in the experimental group were higher than those in the control group, while the percentage of CD8;was lower;and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the nutritional status indicators of patients were positively correlated with CD4;and CD4;/CD8;,and negatively correlated with CD8;(P<0.05).The incidences of incision infection, constipation, and diarrhea in the experimental group were lower than those in the control group(P<0.05).Conclusion Iso-incremental enteral nutrition infusion may significantly improve the nutritional status of patients with pancreatic cancer, increase tolerance to EEN feeding, enhance the immune function, and reduce the risk of complications.