摘要
目的观察术前肠内免疫营养对食管癌新辅助化疗患者营养状态、免疫状况及临床结局的影响。方法选取行食管癌切除手术的患者65例,按随机表分为肠内免疫营养组(EIN组,34例)和常规饮食组(对照组,31例)。所有入组患者术前均行新辅助化疗2周期,并于新辅助化疗结束后3~4周行食管癌根治术。EIN组于新辅助化疗第2疗程结束后1周开始在常规饮食基础上口服肠内免疫营养,直至术前1 d。对照组于新辅助化疗第2疗程结束后只给予常规饮食。观察2组患者新辅助化疗第2疗程结束后1周及术前1 d的体质量指数、肱三头肌皮皱厚度和上臂围。观察2组患者新辅助化疗第2疗程结束后1周、术前1 d、术后1 d、术后1周的营养及免疫指标。观察2组患者术后1 d下床活动时间完成例数、术后首次肛门排气时间、术后肠内营养相关不良反应发生例数、术后肺炎发生例数和住院时间。结果2组患者在性别、年龄、吸烟史、饮酒史、临床分期、肿瘤位置等方面比较差异无统计学意义(P>0.05)。术前1 d EIN组的体质量指数、肱三头肌皮皱厚度和上臂围与对照组相比差异有统计学意义(均P<0.05)。术前1 d EIN组营养指标和免疫指标显著上升(P<0.05);术后1 d 2组各营养指标和免疫指标均明显下降,与术前1 d相比差异有统计学意义(P<0.05);术后1周2组患者各指标较术后1 d显著上升(P<0.05)。术后1周2组指标和免疫指标相比差异有统计学意义(P<0.05)。术后下床活动完成例数EIN组较对照组明显增多,术后肠内营养相关不良反应(腹胀、腹泻)及肺炎并发症例数EIN组较对照组少,术后首次排气时间和住院时间EIN组比对照组均较短,差异有统计学意义(P<0.05)。结论对于食管癌新辅助化疗患者,术前口服肠内免疫营养,能改善患者的营养状态和免疫状况,增加患者对手术的耐受力,降低并发症的发生,促进患者的快速康复�
Objective To evaluate the nutritional status,immune function and clinical effectiveness of early enteral immunonutrition in patients of esophageal cancer before operation.Methods Sixty-five patients received totally esophagectomy were enrolled in this randomized controlled trial.The patients were randomly divided into enteral immunonutrition group(EIN group,n=34)and regular diet group(control group,n=31).All patients underwent neoadjuvant chemotherapy for 2 cycles before surgery,and patients underwent totally esophagectomy after finishing neoadjuvant chemotherapy for 3 to 4 weeks.The EIN group was given oral enteral immunonutrition on the basis of regular diet at the 7th day after the end of the second course of neoadjuvant chemotherapy until one day before surgery.The control group was given the regular diet after the end of the second course of neoadjuvant chemotherapy.Data of body mass index,triceps skin wrinkle thickness and upper arm circumference were compared one week after the end of the second course of neoadjuvant chemotherapy and 1 day before surgery between two groups.The levels of nutritional indexes and immune indexes were compared one week after the second course of neoadjuvant chemotherapy,one day before surgery and one day,one week after surgery between two groups.The number of getting out of bed,postoperative enteral nutrition-related side effects,postoperative pneumonia complications,the time of first postoperative anal exhaust and the length of hospitalization were also compared between the two groups.Results There were no significant differences in gender,age,tobacco smoking,drinking,tumor location and clinical stage between the two groups(P>0.05).There were significant differences in the body mass index,triceps skin wrinkle thickness and upper arm circumference on the first day before operation between the two groups(P<0.05).The nutritional indexes and immune indexes increased significantly one day before surgery in EIN group(P<0.05).The nutritional indexes and immune indexes were significan
作者
徐延昭
张缜
郭强
张月峰
温士旺
张帆
田子强
XU Yan-zhao;ZHANG Zhen;GUO Qiang;ZAHNG Yue-feng;WEN Shi-wang;ZHANG Fan;TIAN Zi-qiang(Department of Thoracic Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Thoracic Surgery,the Affiliated Hospital of Hebei University)
出处
《天津医药》
CAS
北大核心
2020年第2期136-140,共5页
Tianjin Medical Journal
基金
河北省医学科学研究重点课题计划项目(20170148)。
