摘要
目的探讨免疫型肠内营养对食管癌患者术后免疫功能和生活质量的影响。方法自2014年1月至2016年1月,前瞻性收集中国医科大学附属盛京医院收治的食管癌患者80例;食管癌术后,按照完全随机数字表法,将患者随机分为观察组和对照组,每组各40例,观察组采用免疫性肠内营养进行营养支持,对照组采用普通肠内营养进行肠内营养支持。主要观察指标为白蛋白、C反应蛋白、住院时间、T细胞亚群和生活质量。结果两组患者术后第1天CD4+T细胞和CD8+T细胞比例均差异无统计学意义[(25.85±2.21)%比(25.08±2.09)%,P=0.111和(29.18±3.44)%比(28.75±3.41)%,P=0.576]。与对照组比较,观察组患者术后第7天和第14天CD4+T细胞比例显著增高[(27.74±2.65)%比(25.29±2.74)%,P<0.001和(27.95±2.71)%比(25.52±2.47)%,P<0.001];第7天和第14天CD8+T细胞比例显著增高[(30.85±2.79)%比(28.44±2.69)%,P<0.001和(30.91±3.79)%比(29.07±3.64)%,P=0.030]。两组患者术后第1天和第14天白蛋白均差异无统计学意义(P>0.05)。两组患者术前C反应蛋白差异无统计学意义[(18.58±5.39)mg·L-1比(19.12±6.24)mg·L-1,P=0.617]。与对照组比较,观察组患者术后第14天外周血中C反应蛋白显著降低[(7.37±2.85)mg·L-1比(11.57±4.85)mg·L-1,P<0.001];健康相关的生存质量评分显著增高[(79.57±8.57)分比(74.38±7.12)分,P=0.035];住院时间显著缩短[(21.73±3.26)d比(24.38±4.28)d,P=0.002]。结论免疫型肠内营养有助于提高食管癌术后患者免疫功能,改善患者生活质量。
Objective To explore the influence of immune -based enteral nutrition on immune function and quality of life in patients with esophageal cancer after operation .Methods From January 2014 to January 2016,80 patients with esophageal cancer were pro -spectively collected in Shengjing Hospital of China Medical University .According to the principle of complete random number table ,the patients were randomly assigned into study group and control group after the operation ,40 cases in each group.In the study group,the immune-based enteral nutrition was used ,while the control group was supported by ordinary enteral nutrition .The main outcome meas-ures were albumin,C reactive protein,length of hospital stay,T cell subsets and quality of life.Results There were no significant differences in proportions of CD4 ＋T cells and CD8 ＋T cells between the two groups on the first day after the operation [（25.85 ± 2.21） vs （25.08 ±2.09）%,P =0.111 and （29.18 ±3.44） vs （28.75 ±3.41） %,P =0.576].Compared with the control group , the proportions of CD4 ＋T cells were significantly increased on the seventh day and fourteenth day after the operation in the study group [（27.74 ±2.65） vs （25.29 ±2.74）%,P 〈0.001 and （27.95 ±2.71） vs （25.52 ±2.47）%,P 〈0.001],and the proportions of CD8 ＋T cells were significantly increased [（30.85 ±2.79） vs （28.44 ±2.69）%,P 〈0.001 and （30.91 ±3.79） vs （29.07 ± 3.64）%,P =0.030].There was no significant difference in albumin between the two groups on the first day and fourteenth day after surgery （P 〉0.05）.There was no significant difference in peripheral blood C reactive protein between the two groups on the first day after the operation [（18.58 ±5.39） vs （19.12 ±6.24） mg· L-1 ,P =0.617].Compared with the control group ,the C reactive pro-tein in the peripheral blood was significantly reduced on the fourteenth day after the operation in the study group [（7.37 ±2.85） vs （11.57 ±4.85） mg· L-1 ,P 〈0.001];the he
作者
张思文
ZHANG Siwen(Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China)
出处
《安徽医药》
CAS
2018年第6期1099-1102,共4页
Anhui Medical and Pharmaceutical Journal
关键词
肠道营养
谷氨酰胺
食管肿瘤
免疫
生活质量
Enteral Nutrition
Glutamine
Esophageal neoplasms
Immunity
Quality of life
