摘要
目的 :观察肠内免疫营养对恶性梗阻性黄疸病人术后的临床应用效果。 方法 :该研究是前瞻、随机、单盲和对照的临床研究。将 4 0例接受手术治疗的恶性梗阻性黄疸病人 ,随机分为标准肠内营养组和肠内免疫营养组 ,每组 2 0例。两组病人年龄、性别、手术方式等方面均有可比性。术中空肠造口 ,术后按 1 2 5 .5 2kJ/(kg·d)给予等热量的肠内营养支持 ,连续应用 1 0天以上。标准肠内营养组给予标准肠内营养剂 ,肠内免疫营养组给予肠内免疫营养剂 (Supportan)。分别于手术前 2天 ,术后第 4和第 1 4天检测血清清蛋白、前清蛋白、谷丙转氨酶、谷草转氨酶、外周血T淋巴细胞亚群和血清IL 6水平。 结果 :①术后第 1 4天时 ,肠内免疫营养组血清清蛋白水平明显高于标准肠内营养组 (P <0 .0 5 )。②术后第 1 4天时 ,谷丙转氨酶、谷草转氨酶两组间无显著性差异。③术后第 4天时肠内免疫营养组CD4 /CD8比值明显高于标准肠内营养组 (P <0 .0 1 )。与术前 2天相比 ,术后第 1 4天时肠内免疫营养组的CD4 /CD8比值明显升高 (P <0 .0 5 ) ,而在标准肠内营养组则无显著性差异。④术后第 1 4天时 ,肠内免疫营养组血清IL 6水平明显低于标准肠内营养组 (P <0 .0 5 )。 结论 :恶性梗阻性黄疸病人手术后应用肠内免疫营养能改善病人?
Objective: Patients with malignant obstructive jaundice (OJ) often have malnutrition associated with increased perioperative morbidity. This study was designed to investigate the clinical effects of immune enteral nutrition in these patients. Methods: A series of 40 malignant OJ patients were investigated prospectively. These patients were equally divided into standard enteral nutrition group and immune enteral nutrition group randomly. Two groups were compatible in ages, genders and operation modes. The standard enteral nutrition agent was used to standard enteral nutrition group and supportan to immune enteral group with the same total energy of 30 kcal/(kg·d) after operation. The enteral nutrition support time was not less than ten days. Plasma albumin, PAB, ALT, AST, the percentage of T lymph cell subgroups and the concentration of serum IL 6 were detected 2 days before operation, the 4 th day and the 14 th day after operation. Results: ① In the 14 th day after operation, the level of ALB in immune enteral group was higher than that in standard enteral nutrition group ( P <0.05). ② The level of ALT, AST in immune enteral nutrition group did not declined more obviously than that in standard enteral nutrition group. ③The ratio of CD4/CD8 in immune enteral nutrition group was higher than that in standard enteral nutrition group( P <0.01). The ratio of CD4/CD8 in the 14 th day after operation increased in immune enteral nutrition group ( P <0.05), and did not change in standard enteral nutrition group. ④ The level of serum IL 6 in immune enteral nutrition group was lower than that in standard enteral nutrition group( P <0.05). Conclusions: Immune enteral nutrition is a safe and effective support method to malignant OJ patients after operation,and can improve the nutrition state of patients, enhance the function of immune system and regulate turbulent inflammatory response more obviously than standard enteral nutrition.
出处
《肠外与肠内营养》
CAS
2004年第4期205-208,共4页
Parenteral & Enteral Nutrition
