摘要
目的探讨术前营养风险筛查联合营养支持对结直肠癌患者腹腔镜手术后免疫功能、营养状态和疗效的影响。方法选择2016年1月至2018年6月在温州医科大学附属第一医院和温州医科大学附属慈溪医院治疗的结直肠癌患者138例,根据术前营养风险评估,分为有营养风险组(n=53)和不存在营养风险的对照组(n=85),前者再分为接受营养支持组(A组,n=32)和未接受营养支持组(B组,n=21)。比较三组术后肠功能恢复情况、免疫功能及相关营养指标。结果 A组首次排气时间、首次排便时间明显短于B组(P<0.05),但均较对照组延长(P<0.05);A组和对照组半流质饮食时间及住院天数明显短于B组(P<0.05);术后,A组和对照组血清白蛋白(Alb)、前白蛋白(PA)和转铁蛋白(Tf)明显高于B组(P<0.05),对照组血清Alb和PA明显高于A组(P<0.05);术后,三组IgA、IgG和IgM差异明显,其中A组各指标水平最高,对照组次之,B组最低(P<0.05);三组并发症发生率无明显差异(P>0.05)。结论术前营养风险筛查,对有营养风险的结直肠癌患者给予肠内营养支持,可有效改善术后营养状况,提高免疫功能,促进术后恢复,同时减少术后并发症的发生。
Objective To investigate the effect of preoperative nutritional risk screening combined with nutritional support on immune function, nutritional status and curative effect of patients with colorectal cancer (CRC) underwent laparoscopic surgery. Methods A total of 138 patients with CRC who underwent laparoscopic surgery in the First Affiliated Hospital of Wenzhou Medical University and Cixi Hospital Affiliated to Wenzhou Medical University from Jan. 2016 to Jun. 2018 were enrolled. All patients underwent preoperative nutritional risk assessment. Those with nutritional risk were divided into nutritional support group (group A, n=32) and nonnutritional support group (group B, n=21), those without nutritional risk were included in the control group (n=85). The recovery of intestinal function, immune function and related nutritional indicators were compared among the three groups. Results The first exhaust time and defecation time in group A were significantly shorter than those in group B (P<0.05), and were significantly longer than those in the control group (P<0.05). The half-fluid diet time and hospitalization duration in group A and the control group were significantly shorter than those in group B (P<0.05). After operation, serum albumin (Alb), prealbumin (PA) and transferrin (Tf) in group A and the control group were significantly higher than those in group B (P<0.05), while serum Alb and PA in the control group were significantly higher than those in group A (P<0.05). After operation, there were significant differences in IgA, IgG and IgM among the three groups, with the highest level in group A, the second in the control group and the lowest in group B (P<0.05). There was no significant difference in the incidence of complications among the three groups (P>0.05). Conclusion For CRC patients with nutritional risk preoperative nutritional risk screening and enteral nutrition support can effectively improve nutritional status, improve immune function, promote postoperative recovery and reduce postoperative compl
作者
龚沛榕
胡余杰
范晓东
胡邓迪
张炯炯
陈钢
GONG Pei-rong;HU Yu-jie;FAN Xiao-dong;HU Deng-di;ZHANG Jiong-jiong;CHEN Gang(Department of General Surgery, Cixi Hospital Affiliated to Wenzhou Medical University,Ningbo, Zhejiang 315300, China;Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325015, China)
出处
《肝胆胰外科杂志》
CAS
2019年第6期344-347,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
结直肠癌
营养风险筛查
营养支持
免疫功能
营养状态
colorectal cancer
nutritional risk screening
nutritional support
immune function
nutritional status
