胰腺癌术后行早期肠内免疫营养支持促进机体胃肠功能、免疫功能恢复的临床研究

Effect of postoperative early enteral immunonutrition on recovery of gastrointestinal function and immune function in patients with pancreatic cancer

摘要:

目的  分析胰腺癌术后行早期肠内免疫营养支持促进机体胃肠功能、免疫功能恢复的效果。方法  选取2008年9月-2013年11月间在该院接受手术治疗的胰腺癌患者60例作为研究对象。根据术后接受的营养干预方式不同随机分为观察组及对照组，对照组患者接受术后常规营养干预，观察组患者接受术后早期肠内免疫营养支持。对比两组患者的干预后营养状况、胃肠功能、免疫功能等差异。结果  观察组患者接受早期肠内免疫营养支持，术后1周及2周的血清白蛋白、前白蛋白、转铁蛋白水平均高于对照组患者（P <0.05）；观察组患者接受肠内营养后的肠鸣音恢复时间、肛门排气时间、排便时间及胃管留置时间均短于对照组患者（P <0.05）；观察组患者接受营养干预后1周，免疫球蛋白G、免疫球蛋白A、免疫球蛋白M、CD3+、CD4+、CD4+/CD8+值高于对照组患者，CD8+值低于对照组患者（P <0.05）；观察组患者发生腹泻、腹胀、便秘的例数显著低于对照组。结论  胰腺癌患者接受术后早期肠内免疫营养支持，可以有效改善患者术后营养状态、促进胃肠功能恢复、提升机体整体免疫功能，具有积极的临床意义。

Abstract:

Objective To analyze the effect of postoperative early enteral immunonutrition on gastrointestinal function and immune function recovery in pancreatic cancer patients. Methods Sixty cases of pancreatic cancer patients undergoing surgery in our hospital between September 2008 and November 2013 were chosen as research subjects. According to different nutritional intervention the patients were randomized into observation group and control group. The patients in the control group received routine nutritional intervention, while the patients in the observation group received early enteral immunonutrition. Nutritional status, gastrointestinal function and immune function were compared between the two groups after intervention. Results Serum albumin, prealbumin and transferrin levels in the observation group were higher than those in the control group 1 week and 2 weeks after treatment (P < 0.05) The recovery time of bowel sound, flatus, bowel movement and stomach retention time in the observation group were shorter than those in the control group (P < 0.05). IgG, IgA, IgM, CD3+, CD4+ and CD4+/CD8+ values in the observe group were higher than those in the control group, while CD8+ value was lower than that in the control group (P < 0.05). The incidences of abdominal distension, diarrhea and constipation in the observation group were lower than those in the control group. Conclusions Early enteral immunonutrition after surgery in pancreatic cancer patients can effectively improve the nutritional status of patients, promote recovery of gastrointestinal function, improve the body's overall immune function, and has a positive significance.