摘要
目的探讨肠内营养对肺癌术后患者的伤口愈合及免疫功能的影响。方法将72例肺癌手术患者按随机数字表法分为对照组和观察组,每组36例。对照组患者于术后第2～8天给予常规饮食及肠外营养静脉输注支持治疗。观察组患者在对照组基础上加用肠内营养制剂瑞能口服。分别于术前、术后第1天及术后第8天测定血清IgA、IgG、IgM、T细胞亚群及白蛋白、前白蛋白水平。并记录两组患者手术切口愈合的时间及术后切口出血、感染等并发症的发生率。结果与术前及术后第1天相比较,观察组患者术后第8天的血清IgG、CD3^+、CD4^+、CD4^+/CD8^+、CD56^+、白蛋白及前白蛋白水平均升高明显,差异均有统计学意义(均P<0.05);而IgA、IgM、CD8^+升高不明显,差异均无统计学意义(均P>0.05)。对照组患者术后第8天的血清IgG、IgA、IgM、CD3^+、CD4^+、CD4^+/CD8^+、CD56^+、白蛋白及前白蛋白水平与术前及术后第1天相比较,差异均无统计学意义(均P>0.05)。观察组的手术切口愈合时间短于对照组,差异有统计学意义(P<0.05);两组患者术后感染及出血的发生率均无统计学差异(均P>0.05)。结论肠内营养可以改善肺癌手术患者的免疫功能,并且有助于促进切口愈合。
Objective To investigate the effects of postoperative enteral nutrition(EN) on wound healing and immune function in patients with lung cancer undergoing surgical treatment. Methods Seventy two patients with lung cancer who underwent thoracic surgery were randomly divided into study group and control group with 36 cases in each group. Patients in control group received conventional diets and parenteral nutrition from d 2 to d 8 after surgery;patients in study group were given additional Supportan for EN on the basis of conventional diets and parenteral nutrition. At postoperative d0, d1 and d8 the serum levels of IgA, IgG, IgM, T cell subset, albumin and prealbumin were measured. The healing time of operative incision and postoperative infection and bleeding were documented. Results Serum IgG levels, CD3^+, CD4^+, CD4^+/CD8^+, CD56^+, albumin and prealbumin in study were increased significantly in postoperative d8 compared to those before operation(P<0.05), while there were no significant changes in the serum IgA, IgM and CD8 levels(P >0.05). There were no significantly differences in the serum levels of IgG, IgA, IgM, CD3^+, CD4^+, CD4^+/CD8^+, CD56^+, albumin and prealbumin at all time points in the control group. In study group, the healing time of operative incision was shorter than that in control group(P<0.05), while there were no significantly differences in the postoperative infection rate and bleeding between study group and control group(P >0.05). Conclusion Enteral nutrition can accelerate the healing of operative incision and improve the immune function in patients with lung cancer undergoing surgical treatment.
作者
饶海英
郑彬彬
刘勇
方莹
叶曼
RAO Haiyin;ZHENG Binbin;FANG Ying(Department of Cardiothoracic Surgery,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《浙江医学》
CAS
2019年第6期591-593,599,共4页
Zhejiang Medical Journal
基金
温州市科技计划项目(Y20160588)
关键词
肺癌
手术
免疫功能
肠内营养
Lung cancer
Operation
Immune function
Enteral nutrition(EN)
