摘要
目的探讨老年结直肠癌患者术后早期口服肠内营养制剂的临床效果。方法将100例老年结直肠癌患者随机分为肠内营养组和传统治疗组,每组50例。肠内营养组患者术后早期给予少量多次饮水和肠内营养制剂;传统治疗组患者按照传统围手术期进行输液治疗。比较两组患者半流饮食时间、下床活动时间、排气时间、排便时间、拔除引流管时间;比较两组患者术前及术后的营养学指标、应激指标、免疫学指标;比较两组患者手术前后疼痛(NRS)评分、生活质量(QOL)评分;比较两组患者术后住院时间、住院总费用及术后并发症发生情况。结果肠内营养组患者半流饮食时间、排气时间、排便时间、下床活动时间、拔除引流管时间、NRS评分、术后并发症发生率、术后住院天数及住院总费用均短于或低于传统治疗组,而QOL评分高于传统治疗组(均P <0. 05)。两组患者总蛋白(TP)、ALB、体质指数(BMI)比较,差异有统计学意义(P <0. 05);两组患者TP、ALB、BMI均有随时间变化的趋势(P <0. 05);分组与时间有交互效应(P <0. 05)。两组的C反应蛋白(CRP)、血清皮质醇(Cor)、肿瘤坏死因子α(TNF-α)、PLT计数比较,差异有统计学意义(P <0. 05);两组的CRP、Cor、TNF-α、PLT计数均有随时间变化的趋势(P <0. 05);分组与时间有交互效应(P <0. 05)。两组患者Ig G、Ig M、CD4、CD8比较,差异有统计学意义(P <0. 05);两组的Ig G、Ig M、CD4、CD8均有随时间变化的趋势(P <0. 05);分组与时间有交互效应(P <0. 05)。结论老年结直肠癌患者术后早期口服肠内营养制剂安全有效,能改善患者机体营养状况及免疫功能,减少并发症的发生。
Objective To explore the clinical effect of early postoperative oral enteral nutrients on the elderly patients with colorectal carcinoma.Methods One hundred elderly patients with colorectal carcinoma were randomly divided into enteral nutrition group and traditional therapy group,with50cases in each group.The patients in the enteral nutrition group were given a little water and enteral nutrients several times in the early stage after operation;the patients in the traditional therapy group received conventional perioperative infusion therapy.The duration of semi-liquid diet,ambulation time,exhaust time,defecation time,and time to drainage tube extubation were compared between the two groups;the preoperative and postoperative indicators were compared between the two groups,including nutrition parameters,stress response parameters,immunological parameters,Numeric Rating Scale(NRS)score and quality of life(QOL)score;and the postoperative hospital stay,total hospitalization costs and incidence of postoperative complications were compared between the two groups as well.Results Compared with the traditional therapy group,the enteral nutrition group had shorter duration of semi-liquid diet,exhaust time,defecation time,ambulation time and time to drainage tube extubation,lower NRS score,incidence rate of postoperative complications,postoperative hospital stay and total hospitalization costs,and higher QOL score(all P<0.05).There were statistically significant difference in the total protein(TP),ALB and body mass index(BMI)between the two groups(P<0.05);TP,ALB and BMI presented a tendency to change with time in both groups(P<0.05);and there was an interaction between grouping effect and time effect(P<0.05).There were statistically significant difference in the C-reactive protein(CRP),serum cortisol(Cor)and tumor necrosis factorα(TNF-α)and PLT count between the two groups(P<0.05);CRP,Cor,TNF-αand PLT count presented a tendency to change with time in both groups(P<0.05);and there was an interaction between grouping effect
作者
陈建社
刘锦新
CHEN Jian-she;LIU Jin-xin(Department of Gastroenterology,the First People's Hospital of Nanning,Nanning 530021,China)
出处
《广西医学》
CAS
2018年第22期2692-2695,2701,共5页
Guangxi Medical Journal
关键词
结直肠癌
老年人
肠内营养
术后
早期
应激反应
免疫功能
Colorectal cancer
Elderly people
Enteml nutrition
Postopemtion
Early stage
Stress response
Immune function
