文章摘要
程蓉,谢颖,樊博,陈海梅,余香梅,王力.肠内营养支持对患者肝癌切除术后应激指标及预后的影响[J].中国临床保健杂志,2018,21(5):613-616.
肠内营养支持对患者肝癌切除术后应激指标及预后的影响
Effects of enteral nutrition on stress indicators and prognosis of patients after liver cancer resection
投稿时间:2018-06-10  
DOI:10.3969/J.issn.1672-6790.2018.05.011
中文关键词: 肝切除术  肝肿瘤  肠道营养  胃肠外营养  预后
英文关键词: Hepatectomy  Liver neoplasms  Enteral nutrition  Parenteral nutrition  Prognosis 〖FL
基金项目:四川省医学会科研课题计划(S17041)
作者单位E-mail
程蓉 中国人民解放军第四五二医院重症医学科,成都 610021 120916280@qq.com 
谢颖 四川南充市中心医院麻醉科  
樊博 中国人民解放军第四五二医院重症医学科,成都 610021  
陈海梅 中国人民解放军第四五二医院重症医学科,成都 610021  
余香梅 中国人民解放军第四五二医院重症医学科,成都 610021  
王力 中国人民解放军第四五二医院重症医学科,成都 610021  
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中文摘要:
      目的 探讨肝癌切除术后应用肠内营养支持,对患者营养状况、转氨酶、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及预后的影响。方法 以实施肝癌切除术的78例为研究对象,按照随机数字表法将其分为研究组39例和对照组39例,两组术后分别采用肠内营养支持与肠外营养支持,测量两组患者的术前、后的营养状况[体质量、上臂围、白蛋白(ALB)]及转氨酶[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]、TNF-α 、IL-6水平,记录干预后的预后(术后并发症和3年无瘤生存率)情况及不良反应发生情况,并进行统计学分析。结果 术前,两组体质量、上臂围及ALB、ALT、AST、TNF-α、IL-6水平差异均无统计学意义(P>0.05);干预后,两组体质量及上臂围差异无统计学意义(P>0.05),研究组ALB水平高于对照组,ALT、AST、TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率(5.1%)低于对照组(20.5%),3年无瘤生存率高于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率5.1%低于对照组23.1%,差异有统计学意义(P<0.05)。结论 于肝癌切除术后行肠内营养支持可改善患者的营养状况,降低转氨酶、TNF-α、IL-6水平及术后并发症、不良反应等,提高3年无瘤生存率。
英文摘要:
      Objective To explore the effects of enteral nutrition support on nutritional status,aminotransferase,tumor necrosis factor-alpha (TNF-alpha),interleukin-6 (IL-6) and prognosis in patients after liver cancer resection. Methods Seventy-eight patients after liver cancer resection were selected and divided into the study group(39 cases) and the control group(39 cases)according to random number table.The two groups were treated with enteral nutrition support and parenteral nutrition support.The nutritional status (weight,arm circumference,albumin),serum ALB and transaminase (ALT,AST),TNF-alpha and IL-6 levels of the two groups in preoperative and postoperative were measured.The prognosis (postoperative complications and 3 year tumor free survival) and adverse reaction were record,and statistical treatment was done. Results There was no statistical difference between the two groups in weight,upper arm circumference and serum ALB,ALT,AST,TNF-alpha and IL-6 before operation (P>0.05).There was no significant difference between the two groups of weight and upper arm circumference after operation (P>0.05).The serum ALB of the study group was higher than that of the control group,and the levels of serum ALT,AST,TNF-alpha and IL-6 water were lower than those of the control group.There were significant differences between the two groups (P<0.05).The incidence of postoperative complications of the study group (5.1%) was lower than that of the control group (20.5%),and the 3 year tumor free survival rate of the study group was higher than that of the control group,the difference was statistically significant (P<0.05).The incidence of adverse reactions of the study group(5.1%) was lower than that in the control group (23.1%),the difference was statistically significant (P<0.05). Conclusion Enteral nutrition support can improve the nutritional status of the patients after liver cancer resection,reduce the levels of aminotransferase,TNF-alpha,IL-6 and postoperative complications and adverse reactions,and improve the 3 year tumor free survival.
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