摘要
目的探讨早期肠内营养时机选择对食管癌患者术后营养状况和免疫功能的影响。方法食管癌手术患者69例随机均分为三组,分别于术后12 h(12 h组)、24 h(24 h组)和48 h(48 h组)实施肠内营养,记录术后排气、排便和住院时间以及并发症发生情况。于术后肠内营养结束时测定血清白蛋白水平,并检测体液免疫和细胞免疫相关指标。结果12 h组和24 h组的肠内营养结束时血清白蛋白水平均高于48 h组(P<0.05)。12 h组的术后排便时间早于48 h组,12 h组和24 h组的术后住院时间短于48 h组(P<0.05),但三组患者术后排气时间及术后相关并发症发生率无统计学差异(P>0.05)。肠内营养结束时,12 h组和24 h组的免疫球蛋白(Ig)A、IgG和IgM水平高于48 h组(P<0.05),12h组IgA和IgG水平也高于24 h组(P<0.05)。肠内营养结束时,12 h组和24 h组的CD3^+、CD4^+和CD8^+T细胞百分比高于48 h组(P<0.05),12 h组的CD3^+T细胞百分比也高于24 h组(P<0.05)。结论术后24 h内予肠内营养支持可有效改善食管癌患者术后营养状况,提高免疫功能,加快患者术后恢复;条件许可时,肠内营养可提前至术后12 h内开始。
Objective To explore the effects of early enteral nutrition initiation timing on nutritional status and immune function of the patients underwent esophageal carcinoma resection.Methods A total of 69 patients was equally randomized into three groups.Postoperative enteral nutrition started at 12 hours(group A),24 hours(group B)or 48 hours(group C)after the surgery.The times of postoperative exhaust,defecation and hospital stay were recorded.Postoperative complications were observed.At the end of enteral nutrition,plasma albumin was detected and the indicators related to humoral and cellular immunity were measured.Results Plasma albumin levels at the end of enteral nutrition were significantly higher in groups of A and B than those in group C(P<0.05).Postoperative exhaust time was significantly earlier in group A than that in group C(P<0.05).Hospital stay was shorter in groups of A and B than that in group C(P<0.05).There were no significant differences in postoperative exhaust time and complication incidence among the three groups(P>0.05).At the end of enteral nutrition,the levels of IgA,IgG and IgM were higher in groups of A and B than those in group C(P<0.05)and the levels of IgA and IgG were higher in group A than those in group B(P<0.05).At the end of enteral nutrition,the percentages of CD3^+,CD4^+and CD8^+T cells were higher in groups of A and B than those in group C(P<0.05)and the CD3^+T cells percentage was higher in group A than that in group B(P<0.05).Conclusion Enteral nutrition support within 24 hours after operation can effectively improve postoperative nutritional status,improve immune function and accelerate postoperative recovery of the patients with esophageal cancer,which can be advanced to 12 hours after operation when conditions permit.
作者
蒋薛伟
单一波
糜烨东
黄斌
虞桂平
JIANG Xuewei;SHAN Yibo;MI Yedong(Department of Cardiothoracic Surgery,Affiliated Jiangyin people’s Hospital,Southeast University Medical College,Jiangyin 214400,CHINA)
出处
《江苏医药》
CAS
2020年第7期697-700,共4页
Jiangsu Medical Journal
关键词
食管癌
肠内营养
营养状况
免疫功能
Esophageal cancer
Enteral nutrition
Nutrition status
Immune function
