中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
4期
475-478
,共4页
李英杰%宋伟勇%吕新厅%李宁%吕志良
李英傑%宋偉勇%呂新廳%李寧%呂誌良
리영걸%송위용%려신청%리저%려지량
肠道营养%胃肠外营养%胃切除术%营养状况%免疫
腸道營養%胃腸外營養%胃切除術%營養狀況%免疫
장도영양%위장외영양%위절제술%영양상황%면역
Enteral nutrition%Parenteral nutrition%Gastrectomy%Nutritional status%Immunity
目的 比较早期肠外营养与肠内营养对全胃切除术患者营养、免疫及肝功能状态的影响.方法 选取90例全胃切除术患者为研究对象,将所有患者分为A组(早期肠外营养组)和B组(早期肠内营养组)各45例,比较两组患者干预前与干预后3、10 d的营养状态相关指标、免疫功能指标及肝功能指标.结果 B组干预后3、10 d的营养状态相关指标[3 d:总蛋白(TP)(68.35±3.02) g/L、清蛋白(A) (38.94 ±4.69)g/L、前清蛋白(PAB)(273.54±29.68) mg/L、转铁蛋白(TRF)(2.14±0.29) g/L、血红蛋白(Hb) (129.84±7.92)g/L;10 d:总蛋白(72.59±3.52) g/L、清蛋白(42.31 ±5.49)g/L、前清蛋白(305.57±30.95) mg/L、转铁蛋白(2.78 ±0.31)g/L、血红蛋白(135.87±8.95) g/L]、免疫功能指标[3d:免疫球蛋白A(IgA) (0.94 ±0.10) g/L、免疫球蛋白G(IgG) (9.24±0.63) g/L、免疫球蛋白M(IgM) (1.51±0.14) g/L、红细胞补体C3b受体(RBC-C3bR)(10.54±0.52)％、红细胞免疫复合物花环率(RBC-ICR)(12.21±1.41)％;10 d:IgA(1.23±0.15) g/L、IgG(10.98±0.72) g/L、IgM(1.71±0.18) g/L、RBC-C3 bR(13.74±0.69)％、RBC-ICR(9.27±1.05)％]及肝功能指标[3 d:谷丙转氨酶(ALT) (32.59 ±3.56) U/L、谷草转氨酶(AST) (33.95 ±4.03) U/L、总胆红素(TBIL)(12.07±1.38) μmol/L、谷酰转肽酶(GGT)(24.03±2.59) U/L; 10 d:ALT(22.93±3.18) U/L、AST(24.84±3.29) U/L、TBIL(10.50±0.96)μmol/L、GGT(20.70±2.49) U/L]均明显优于A组[3 d:总蛋白(64.59 ±2.83)g/L、清蛋白(35.53 ±4.37) g/L、前清蛋白(224.96±25.50) rmg/L、转铁蛋白(1.63±0.20) g/L、血红蛋白(121.03±7.18) g/L、IgA (0.68±0.07) g/L、IgG (7.32±0.51) g/L、IgM(1.12 ±0.10) g/L、RBC-C3bR(8.13±0.40)％ 、RBC-ICR(14.59±1.54)％ 、ALT(40.26±4.13) U/L、AST(40.95 ±4.26) U/L、TBIL(16.37±1.75) μmol/L、GGT(31.45±2.97) U/L; 10 d:总蛋白(66.96 ±2.97) g/L、清蛋白(36.01±4.43) g/L、前清蛋白(241.35±26.63) mg/L、转铁蛋白(1.86 ±0.24) g/L、血红蛋白(127.69±7.73) g/L、IgA(0.81±0.08) g/L、IgG(8.54±0.55) g/L、IgM(1.28±0.12) g/L、RBC-C3 bR(8.52±0.46)％、RBC-ICR(13.07±1.46)％、ALT(31.52±3.84) U/L、AST(33.54±3.90) U/L 、TBIL(13.21±1.41) μmol/L、GGT(25.39±2.65) U/L],且B组上述指标干预后10d优于干预后3d,差异均有统计学意义(P＜0.05).结论 早期肠内营养对全胃切除术患者的营养、免疫及肝功能状态的改善均发挥着积极的作用,为患者的术后康复提供了必要的前提.
目的 比較早期腸外營養與腸內營養對全胃切除術患者營養、免疫及肝功能狀態的影響.方法 選取90例全胃切除術患者為研究對象,將所有患者分為A組(早期腸外營養組)和B組(早期腸內營養組)各45例,比較兩組患者榦預前與榦預後3、10 d的營養狀態相關指標、免疫功能指標及肝功能指標.結果 B組榦預後3、10 d的營養狀態相關指標[3 d:總蛋白(TP)(68.35±3.02) g/L、清蛋白(A) (38.94 ±4.69)g/L、前清蛋白(PAB)(273.54±29.68) mg/L、轉鐵蛋白(TRF)(2.14±0.29) g/L、血紅蛋白(Hb) (129.84±7.92)g/L;10 d:總蛋白(72.59±3.52) g/L、清蛋白(42.31 ±5.49)g/L、前清蛋白(305.57±30.95) mg/L、轉鐵蛋白(2.78 ±0.31)g/L、血紅蛋白(135.87±8.95) g/L]、免疫功能指標[3d:免疫毬蛋白A(IgA) (0.94 ±0.10) g/L、免疫毬蛋白G(IgG) (9.24±0.63) g/L、免疫毬蛋白M(IgM) (1.51±0.14) g/L、紅細胞補體C3b受體(RBC-C3bR)(10.54±0.52)％、紅細胞免疫複閤物花環率(RBC-ICR)(12.21±1.41)％;10 d:IgA(1.23±0.15) g/L、IgG(10.98±0.72) g/L、IgM(1.71±0.18) g/L、RBC-C3 bR(13.74±0.69)％、RBC-ICR(9.27±1.05)％]及肝功能指標[3 d:穀丙轉氨酶(ALT) (32.59 ±3.56) U/L、穀草轉氨酶(AST) (33.95 ±4.03) U/L、總膽紅素(TBIL)(12.07±1.38) μmol/L、穀酰轉肽酶(GGT)(24.03±2.59) U/L; 10 d:ALT(22.93±3.18) U/L、AST(24.84±3.29) U/L、TBIL(10.50±0.96)μmol/L、GGT(20.70±2.49) U/L]均明顯優于A組[3 d:總蛋白(64.59 ±2.83)g/L、清蛋白(35.53 ±4.37) g/L、前清蛋白(224.96±25.50) rmg/L、轉鐵蛋白(1.63±0.20) g/L、血紅蛋白(121.03±7.18) g/L、IgA (0.68±0.07) g/L、IgG (7.32±0.51) g/L、IgM(1.12 ±0.10) g/L、RBC-C3bR(8.13±0.40)％ 、RBC-ICR(14.59±1.54)％ 、ALT(40.26±4.13) U/L、AST(40.95 ±4.26) U/L、TBIL(16.37±1.75) μmol/L、GGT(31.45±2.97) U/L; 10 d:總蛋白(66.96 ±2.97) g/L、清蛋白(36.01±4.43) g/L、前清蛋白(241.35±26.63) mg/L、轉鐵蛋白(1.86 ±0.24) g/L、血紅蛋白(127.69±7.73) g/L、IgA(0.81±0.08) g/L、IgG(8.54±0.55) g/L、IgM(1.28±0.12) g/L、RBC-C3 bR(8.52±0.46)％、RBC-ICR(13.07±1.46)％、ALT(31.52±3.84) U/L、AST(33.54±3.90) U/L 、TBIL(13.21±1.41) μmol/L、GGT(25.39±2.65) U/L],且B組上述指標榦預後10d優于榦預後3d,差異均有統計學意義(P＜0.05).結論 早期腸內營養對全胃切除術患者的營養、免疫及肝功能狀態的改善均髮揮著積極的作用,為患者的術後康複提供瞭必要的前提.
목적 비교조기장외영양여장내영양대전위절제술환자영양、면역급간공능상태적영향.방법 선취90례전위절제술환자위연구대상,장소유환자분위A조(조기장외영양조)화B조(조기장내영양조)각45례,비교량조환자간예전여간예후3、10 d적영양상태상관지표、면역공능지표급간공능지표.결과 B조간예후3、10 d적영양상태상관지표[3 d:총단백(TP)(68.35±3.02) g/L、청단백(A) (38.94 ±4.69)g/L、전청단백(PAB)(273.54±29.68) mg/L、전철단백(TRF)(2.14±0.29) g/L、혈홍단백(Hb) (129.84±7.92)g/L;10 d:총단백(72.59±3.52) g/L、청단백(42.31 ±5.49)g/L、전청단백(305.57±30.95) mg/L、전철단백(2.78 ±0.31)g/L、혈홍단백(135.87±8.95) g/L]、면역공능지표[3d:면역구단백A(IgA) (0.94 ±0.10) g/L、면역구단백G(IgG) (9.24±0.63) g/L、면역구단백M(IgM) (1.51±0.14) g/L、홍세포보체C3b수체(RBC-C3bR)(10.54±0.52)％、홍세포면역복합물화배솔(RBC-ICR)(12.21±1.41)％;10 d:IgA(1.23±0.15) g/L、IgG(10.98±0.72) g/L、IgM(1.71±0.18) g/L、RBC-C3 bR(13.74±0.69)％、RBC-ICR(9.27±1.05)％]급간공능지표[3 d:곡병전안매(ALT) (32.59 ±3.56) U/L、곡초전안매(AST) (33.95 ±4.03) U/L、총담홍소(TBIL)(12.07±1.38) μmol/L、곡선전태매(GGT)(24.03±2.59) U/L; 10 d:ALT(22.93±3.18) U/L、AST(24.84±3.29) U/L、TBIL(10.50±0.96)μmol/L、GGT(20.70±2.49) U/L]균명현우우A조[3 d:총단백(64.59 ±2.83)g/L、청단백(35.53 ±4.37) g/L、전청단백(224.96±25.50) rmg/L、전철단백(1.63±0.20) g/L、혈홍단백(121.03±7.18) g/L、IgA (0.68±0.07) g/L、IgG (7.32±0.51) g/L、IgM(1.12 ±0.10) g/L、RBC-C3bR(8.13±0.40)％ 、RBC-ICR(14.59±1.54)％ 、ALT(40.26±4.13) U/L、AST(40.95 ±4.26) U/L、TBIL(16.37±1.75) μmol/L、GGT(31.45±2.97) U/L; 10 d:총단백(66.96 ±2.97) g/L、청단백(36.01±4.43) g/L、전청단백(241.35±26.63) mg/L、전철단백(1.86 ±0.24) g/L、혈홍단백(127.69±7.73) g/L、IgA(0.81±0.08) g/L、IgG(8.54±0.55) g/L、IgM(1.28±0.12) g/L、RBC-C3 bR(8.52±0.46)％、RBC-ICR(13.07±1.46)％、ALT(31.52±3.84) U/L、AST(33.54±3.90) U/L 、TBIL(13.21±1.41) μmol/L、GGT(25.39±2.65) U/L],차B조상술지표간예후10d우우간예후3d,차이균유통계학의의(P＜0.05).결론 조기장내영양대전위절제술환자적영양、면역급간공능상태적개선균발휘착적겁적작용,위환자적술후강복제공료필요적전제.
Objective To compare the influence of early parenteral nutrition and enteral nutrition on the nutrition,immune,and liver function state of patients with total gastrectomy.Methods A total of 90patients with total gastrectomy in our hospital from July 2010 to October 2012 were selected as research objects,and were randomly divided into group A (early parenteral nutrition group,n =45)and group B(early enteral nutrition group,n =45).The nutrition state indexes,immune state indexes,and liver function indexes of two groups before the intervention and at 3th and 10th day after the intervention were compared.Results The nutrition state indexes[3rd d:TP (68.35 ±3.02)g/L,A (38.94 ±4.69)g/L,PAB (273.54 ±29.68) mg/L,TRF (2.14 ±0.29) g/L,Hb (129.84 ±7.92) g/L;10th d:TP (72.59 ± 3.52)g/L,A (42.31 ±5.49)g/L,PAB (305.57 ±30.95)mg/L,TRF (2.78 ±0.31)g/L,Hb (135.87 ±8.95) g/L],immune state indexes [3rd d:IgA (0.94 ± 0.10) g/L,IgG (9.24 ± 0.63) g/L,IgM (1.51 ±0.14) g/L,RBC-C3bR (10.54 ± 0.52) ％,RBC-ICR (12.21 ± 1.41) ％ ; 10th d:IgA (1.23 ± 0.15) g/L,IgG (10.98 ±0.72)g/L,IgM (1.71 ±0.18) g/L,RBC-C3bR (13.74 ±0.69)％,RBC-ICR (9.27 ±1.05)％],and liver function indexes[3rd d:ALT (32.59 ±3.56)U/L,AST (33.95 ±4.03) U/L,TBIL(12.07± 1.38)μmol/L,GGT (24.03 ±2.59) U/L;10th d:ALT (22.93 ±3.18) U/L,AST (24.84 ±3.29) U/L,TBIL (10.50 ± 0.96) μmol/L,GGT (20.70 ± 2.49) U/L] in group B at 3rd and 10th day after the interventiont were all better than those in group A [3rd d:TP (64.59 ± 2.83)g/L,A (35.53 ±4.37)g/L,PAB (224.96 ±25.50)mg/L,TRF(1.63 ±0.20)g/L,Hb (121.03 ±7.18)g/L,IgA (0.68±0.07)g/L,IgG (7.32 ±0.51)g/L,IgM (1.12 ±0.10)g/L,RBC-C3bR (8.13 ±0.40)％,RBC-ICR (14.59 ±1.54)％,ALT (40.26 ±4.13)U/L,AST (40.95 ±4.26)U/L,TBIL (16.37 ± 1.75)μmol/L,GGT (31.45 ±2.97) U/L;10th d:TP (66.96 ±2.97) g/L,A (36.01 ±4.43) g/L,PAB (241.35 ±26.63) mg/L,TRF (1.86 ± 0.24) g/L,Hb (127.69 ± 7.73) g/L,IgA (0.81 ± 0.08) g/L,IgG (8.54 ±0.55) g/L,IgM (1.28 ± 0.12) g/L,RBC-C3bR (8.52 ± 0.46) ％,RBC-ICR (13.07 ± 1.46) ％,ALT(31.52 ± 3.84) U/L,AST (33.54 ± 3.90) U/L,TBIL (13.21 ± 1.41) μmol/L,GGT (25.39 ± 2.65) U/L],and these indexes in group B at 10th day after the intervention were all significantly better than those at 3rd day after the intervention (all P ＜ 0.05).Conclusions The early enteral nutrition palys an active role in improving the nutrition,immune,and liver function state of patients with total gastrectomy,and it provides the necessary premise for the postoperative rehabilitation of patients.
