早期肠内免疫营养联合ERAS干预对腹腔镜胆囊切除术患者的影响

Effect of early enteral immunonutrition combined with ERAS intervention on patients undergoing laparoscopic cholecystectomy

目的探讨早期肠内免疫营养联合加速康复外科(ERAS)干预对腹腔镜胆囊切除术患者的影响。方法选取我院收治的腹腔镜胆囊切除术患者107例,按照随机抽样法分成两组,对照组53例给予ERAS干预,观察组54例在此基础上增加早期肠内免疫营养干预,观察两组患者的术后消化运动功能、氧化应激指标、免疫球蛋白水平及并发症情况。结果观察组干预后患者术后恢复通气时间、进食流质时间、排便时间及首次下床活动时间明显短于对照组(P<0.05);两组干预后ROS、MDA水平均下降,SOD、GSH-Px水平均上升,但观察组下降、上升幅度明显高于对照组(P<0.05);两组干预后免疫球蛋白水平(IgG、IgA、IgM)均升高,但观察组升高幅度高于对照组(P<0.05);观察组术后的并发症发生率明显低于对照组(P<0.05)。结论早期肠内免疫营养联合ERAS干预能显著改善腹腔镜胆囊切除术患者术后消化运动功能,降低氧化应激反应,提高免疫球蛋白水平,减少术后并发症的发生,值得临床应用。

Objective To explore the effect of early enteral immunonutrition combined with enhanced recovery after surgery(ERAS)intervention on patients undergoing laparoscopic cholecystectomy.Methods 107 cases of patients undergoing laparoscopic cholecystectomy were selected as the research object and randomly divided into two groups.53 cases in the control group got ERAS,54 cases in the observation group were increased early intestinal immune nutrition intervention.The postoperative digestive movement function,oxidative stress index,immunoglobulin levels and complications of the two groups after operation were observed.Results After intervention,the recovery time of ventilation,fluid intake time,defecation time and the first time of getting out of bed in the observation group were significantly shorter than those in the control group(P<0.05).After intervention,ROS and MDA levels decreased in both groups,while SOD and GSH-Px levels increased,but the decrease and increase range in observation group were significantly higher than those in the control group(P<0.05).The levels of immunoglobulin(IgG,IgA,IgM)in both groups were increased after intervention,but the increase range in the observation group was higher than that in control group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Early enteral immunonutrition combined with ERAS intervention can significantly improve postoperative digestive motor function, reduce oxidative stress response, increase the level of immunoglobulin, and reduce postoperative complications in patients with laparoscopic cholecystectomy, which is worthy of clinical use.