CAJ | 학술논문

目的：比较规范化序贯肠内肠外营养支持疗法和仅采用肠外营养支持对消化道肿瘤患者术后营养状况及免疫功能的影响。方法将78例行手术治疗的消化道肿瘤患者随机分为对照组（40例）和观察组（38例），给予对照组患者肠外营养支持，给予观察组患者规范化序贯肠内肠外营养支持，比较和评价两组的治疗效果，包括患者手术引起的并发症情况、住院时间，以及术后一周营养指标、胃肠道恢复情况及对免疫功能的影响等。结果从观察及检测结果来看，观察组比对照组治疗效果更优。其中观察组术后恢复时间和住院时间显著短于对照组（P＜0.05），同时，观察组患者术后的前白蛋白、白蛋白和体重等显著高于对照组（P＜0.05）。与对照组相比，治疗后1周观察组患者CD3+、CD4+显著上升（P＜0.05）。结论胃肠道手术后规范化序贯肠内肠外营养支持疗法可以有效改善患者术后的营养状况，更快地促进胃肠道功能和免疫功能的恢复，缩短住院时间，更快地促进患者术后恢复。
목적：비교규범화서관장내장외영양지지요법화부채용장외영양지지대소화도종류환자술후영양상황급면역공능적영향。방법장78례행수술치료적소화도종류환자수궤분위대조조（40례）화관찰조（38례），급여대조조환자장외영양지지，급여관찰조환자규범화서관장내장외영양지지，비교화평개량조적치료효과，포괄환자수술인기적병발증정황、주원시간，이급술후일주영양지표、위장도회복정황급대면역공능적영향등。결과종관찰급검측결과래간，관찰조비대조조치료효과경우。기중관찰조술후회복시간화주원시간현저단우대조조（P＜0.05），동시，관찰조환자술후적전백단백、백단백화체중등현저고우대조조（P＜0.05）。여대조조상비，치료후1주관찰조환자CD3+、CD4+현저상승（P＜0.05）。결론위장도수술후규범화서관장내장외영양지지요법가이유효개선환자술후적영양상황，경쾌지촉진위장도공능화면역공능적회복，축단주원시간，경쾌지촉진환자술후회복。
Objective To observe and compare the effect of cellular immunologic function and nutritional status on patients with gastrointestinal cancer after surgery treated with standardized sequential enteral parenteral nutrition support therapy and parenteral nutrition support therapy. Method 78 cases of patients with gastrointestinal cancer after surgery were randomly divided into control group(40cases)and observation group(38cases). The control group was treated with parenteral nutrition support and the observation group was treated with standardized sequential enteral parenteral nutritional support therapy.The therapeutic effect of the two groups including the complications caused by surgery, the hospital stay, the nutrition index one week after operation, the recovery of gastrointestinal and the influence on immunologic function were compared and evaluated. Results The treatment effect of observation group is better than those of the conrol group. The postoperative recovery time and hospital stay in the observation group was signiifcantly shorter than those of the control group(P<0.05). The postoperative prealbumin, albumin and body weight of the observation group patients were signiifcantly higher than those of the control group.The CD3+and CD4+increased signiifcantly in observation group(P < 0.05)compared with the control group. Conclusions Standardized sequential enteral parenteral nutrition support therapy after gastrointestinal operation can effectively improve the nutrition status accelerate the recovery of gastrointestinal and immune function shorten the hospital stay and promote the recovery of the patients with gastrointestinal cancer .