CAJ | 학술논문

目的：研究老年大肠癌病人行根治术后进行全肠外营养支持，对术后恢复、胃肠道功能恢复、创口愈合及免疫功能的影响。　方法：对42例65岁以上的大肠癌病人随机分为实验组(TPN组)和对照组(非TPN组)。实验组采用全营养混合液(TNA)经颈内静脉输注，从术后第1天起每天输注，连续8～9天，每天提供非蛋白热量83.7～125.5 kJ(20～30 kcal)/(kg.d)，氮0.12～0.16 g/(kg.d)，脂肪占总热量约20%～30%；对照组术后常规给予葡萄糖与电解质溶液，逐步过渡到口服饮食。观察术后胃肠功能的恢复和创口愈合情况，检测术前第1天、术后第1天及第8天血清白蛋白、前白蛋白、免疫球蛋白(IgG、IgA、IgM)及T细胞亚群的变化。　结果：实验组胃肠功能恢复时间和创口愈合情况均优于对照组，前白蛋白、IgG与IgA水平、CD3+与CD4+细胞百分率均较对照组显著升高(P<0.01)。　结论：全肠外营养对术后老年大肠癌病人具有提高机体营养状况、促进胃肠道功能尽早恢复以及创口更好愈合，同时能明显改善术后应激期机体免疫功能。
목적：연구노년대장암병인행근치술후진행전장외영양지지，대술후회복、위장도공능회복、창구유합급면역공능적영향。　방법：대42례65세이상적대장암병인수궤분위실험조(TPN조)화대조조(비TPN조)。실험조채용전영양혼합액(TNA)경경내정맥수주，종술후제1천기매천수주，련속8～9천，매천제공비단백열량83.7～125.5 kJ(20～30 kcal)/(kg.d)，담0.12～0.16 g/(kg.d)，지방점총열량약20%～30%；대조조술후상규급여포도당여전해질용액，축보과도도구복음식。관찰술후위장공능적회복화창구유합정황，검측술전제1천、술후제1천급제8천혈청백단백、전백단백、면역구단백(IgG、IgA、IgM)급T세포아군적변화。　결과：실험조위장공능회복시간화창구유합정황균우우대조조，전백단백、IgG여IgA수평、CD3+여CD4+세포백분솔균교대조조현저승고(P<0.01)。　결론：전장외영양대술후노년대장암병인구유제고궤체영양상황、촉진위장도공능진조회복이급창구경호유합，동시능명현개선술후응격기궤체면역공능。
Objectives:To study effects of TPN on postoperative patients with colon or rectum cancer,including gut function recovery,wound healing and immune function.　Medthods:42 elder patients with colon or rectum cancer were divided into two groups at randomization,TPN group and control group.From POD+1 to POD+8,TPN group was given TNA daily and control group was given solutions of glucose and electrolyte.Gut function recovery and wound healing were observed and albumin,pre-albumin,IgG,IgA,IgM,CD3+,CD4+ and CD8+ were determined on POD+1 and POD+8.　Results:The recovery of gut function and wound healing in TPN group were better than those in control group,and levels of pre-albumin,IgG,IgA were higher than those in control group.　Conclusions:TPN has positive effects in gut function recovery,wound healing and immune function in postoperative patients with colon or rectum cancer.