重庆医科大学学报
重慶醫科大學學報
중경의과대학학보
UNIVERSITATIS SCIENTIAE MEDICINAE CHONGQING
2010年
1期
100-102
,共3页
原发性肝癌%肝切除术%营养支持%免疫功能%预后
原髮性肝癌%肝切除術%營養支持%免疫功能%預後
원발성간암%간절제술%영양지지%면역공능%예후
Primary hepatic cancer%Hepatectomy%Nutritional support%Immune function%Prognosis
目的:探讨原发性肝癌肝切除术围手术期实施肠内免疫营养支持对其免疫功能及预后的影响.方法:将2003年入我院行肝切除术治疗的原发性肝癌患者58例随机分为免疫营养支持组和常规营养对照组,其他处理一致.检测入院时、术后第1 d和术后第7 d时免疫功能;随访5年,比较两组的预后.结果:肝切除术前肝癌患者CD3+、CD4+、CD8+和CD4+/CD8+含量两组间水平相当.术后第1 d,CD3+、CD4+、CD8+含量较术前明显下降;两组间没有差异.术后第7 d,CD3+、CD4+、CD8+含量较术后第1 d均有上升;而干预组较对照组上升更为明显.干预组和对照组l、2、 3、 4、5年生存率分别为82.8%、70.2%、39.6%、22.6%、20.6%和74.6%、50.1%、25.4%、21.5%、19.5%.其术后1年、2年和3年生存率干预组优于对照组,而4、5年生存率两组则相当,而2组术后总体生存干预组优于对照组(X~2=3.547,P=0.025),多因素分析调整后干预组与对照组对术后生存影响的OR值为0.649,95.0%CI为0.614～0.686.结论:肠内免疫营养支持一定程度上能改善原发性肝癌肝切除术围手术期患者的免疫抑制,并能改善术后生存.
目的:探討原髮性肝癌肝切除術圍手術期實施腸內免疫營養支持對其免疫功能及預後的影響.方法:將2003年入我院行肝切除術治療的原髮性肝癌患者58例隨機分為免疫營養支持組和常規營養對照組,其他處理一緻.檢測入院時、術後第1 d和術後第7 d時免疫功能;隨訪5年,比較兩組的預後.結果:肝切除術前肝癌患者CD3+、CD4+、CD8+和CD4+/CD8+含量兩組間水平相噹.術後第1 d,CD3+、CD4+、CD8+含量較術前明顯下降;兩組間沒有差異.術後第7 d,CD3+、CD4+、CD8+含量較術後第1 d均有上升;而榦預組較對照組上升更為明顯.榦預組和對照組l、2、 3、 4、5年生存率分彆為82.8%、70.2%、39.6%、22.6%、20.6%和74.6%、50.1%、25.4%、21.5%、19.5%.其術後1年、2年和3年生存率榦預組優于對照組,而4、5年生存率兩組則相噹,而2組術後總體生存榦預組優于對照組(X~2=3.547,P=0.025),多因素分析調整後榦預組與對照組對術後生存影響的OR值為0.649,95.0%CI為0.614～0.686.結論:腸內免疫營養支持一定程度上能改善原髮性肝癌肝切除術圍手術期患者的免疫抑製,併能改善術後生存.
목적:탐토원발성간암간절제술위수술기실시장내면역영양지지대기면역공능급예후적영향.방법:장2003년입아원행간절제술치료적원발성간암환자58례수궤분위면역영양지지조화상규영양대조조,기타처리일치.검측입원시、술후제1 d화술후제7 d시면역공능;수방5년,비교량조적예후.결과:간절제술전간암환자CD3+、CD4+、CD8+화CD4+/CD8+함량량조간수평상당.술후제1 d,CD3+、CD4+、CD8+함량교술전명현하강;량조간몰유차이.술후제7 d,CD3+、CD4+、CD8+함량교술후제1 d균유상승;이간예조교대조조상승경위명현.간예조화대조조l、2、 3、 4、5년생존솔분별위82.8%、70.2%、39.6%、22.6%、20.6%화74.6%、50.1%、25.4%、21.5%、19.5%.기술후1년、2년화3년생존솔간예조우우대조조,이4、5년생존솔량조칙상당,이2조술후총체생존간예조우우대조조(X~2=3.547,P=0.025),다인소분석조정후간예조여대조조대술후생존영향적OR치위0.649,95.0%CI위0.614～0.686.결론:장내면역영양지지일정정도상능개선원발성간암간절제술위수술기환자적면역억제,병능개선술후생존.
Objective: The aim of this study was to investigate the immune function and prognosis for patients with primary hepatic cancer who implemented the perioperative enteral immunonutrition support for hepatectomy.Methods: 58 cases of patients with primary hepatic cancer in our hospital in 2003 treated with liver resection were randomly divided into nutritional support fur immune nutrition group and conventional control group.Immune function was detected on admission,1st day and 7th after surgery;5-year follow-up was performed to compare the prognosis of the two groups. Results: Concentration level of CD3+,CD4+,CD8+and CD4+ICD8+in preoperative hepatectomy were the same between the two groups. On the first day after surgery,CD3+,CD4+,CD8+content decreased significantly; there was no difference between the two groups. On the 7th day after surgery,CD3+,CD4+,CD8+content increased;and the intervention group increased more significantly.1,2,3,4,and 5-year survival rates in intervention group and control group were 82.8%,70.2%, 39.6%,22.6%.20.6%and 74.6%,50.1%,25.4%,21.5%,19.5%.The survival rate was higher in the intervention group than the control group at 1-year,2-year and 3-year,while the 4 and 5-yearsurvival rate of the two groups was same,and the intervention group had better overall survival compared with the control group(X~2=3.547,P=0.025).The OR value for enteral immunonutrition support impacting postoperative survival was 0.649 after multivariate analysis adjusted.with 95.0%CI of 0.614-0.686.Conclusion:Enteral immunonutrition support can ameliorate immune suppression in hepatectomy for patients with primary liver cancer during perioperative period,and it also Can improve postoperative survival.
