国产高能型肠内营养对大肠癌术后营养状况、炎性反应和免疫功能的影响

The Effect of High Energy Enteral Nutrition on Postoperative Nutritional Status,Inflammatory Reaction and Immune Function of Colorectal Cancer

目的研究国产高能型肠内营养对大肠癌患者术后营养状况、炎性反应和免疫功能的影响。方法采用随机数表法将63例限期手术大肠癌患者分为研究组(n=31)和对照组(n=32),两组根据理想体重给予等热量104.5k J/kg·d和等氮量0.2 g/kg·d的肠内营养聚合剂,研究组给予高能型肠内营养(力存),对照组给予肠营养聚合剂(能全力),试验期为7天。观察基础人口学资料及临床信息,于术前和术后第7天检测患者营养状况、炎性反应和免疫功能。结果两种肠内营养均能同等改善大肠癌患者术后营养不良,两组血浆白蛋白(ALB)、前白蛋白(TP)、转铁蛋白(FP)水平均高于术前。术后第7天,研究组CD4/CD8比值明显高于对照组及术前的,而血液IL-1、TNF-α水平和CRP水平明显低于对照组与术前的。术后第7天CD4、CD8水平与对照组及术前比较,无显著性意义。两组患者血尿素氮(BUN)、血总胆固醇(TC)、血甘油三酯(TG)各参数比较差别无显著性意义(P均>0.05)。结论国产高能型肠内营养(力存)明显改善大肠癌患者营养不良,降低患者炎性反应和提高细胞免疫应答。

Objective To study the effect of hight energy enteral nutrition on postoperative nutritional status,inflammatory reaction and immune function of colorectal cancer. Methods According to random number table,63 colorectal cancer patients of limited operation were divided into the research group( n = 31) and the control group( n = 32),the 2 groups were given enteral nutrition polymerizer 104. 5 k J / kg · d and nitrogen is 0. 2 g / kg·d according to the ideal weight,the research group received tumor special enteral nutrition( revilife),the control group received whole protein enteral nutrition( Nutrison Fibre),trial period was 7 days. Basic demographic data and clinical information of patients were observed,and the nutritional status,inflammatory reaction and immune function 7 days before and after surgery were detected. Results Both of the 2 types of the enteral nutrition could equally improve the malnutrition of colorectal tumor patients. The level of plasma albumin( ALB),prealbumin( TP),transferrin( FP) of the 2 groups were higher than before the operation. On the 7th day after surgery,the team CD4 / CD8 ratio was significantly higher than that of the control group and before surgery,IL- 1 and TNF alpha level and blood CRP levels are significantly lower than the control group and before surgery. On the 7th day after surgery,there was no significant difference on the comparison of CD4,CD8 levels,the control group and before surgery. There was no significant difference on the 2 groups of patients in body weight,BMI,nutritional risk score,operation method,enteral nutrition,enteral nutrition,start time,serum creatinine( Cr),blood urea nitrogen( BUN),blood blood total cholesterol( TC),triglyceride( TG)( P > 0. 05). Conclusion Domestic hight energy enteral nutrition( Revilife) can significantly improve malnutrition,reduce level of inflammatory factor and promote the tumor growth ability,improve the cellular immune responses.