临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2014年
11期
1148-1152
,共5页
黄疸,阻塞性%经皮经肝穿刺胆管引流%肠道营养%胃肠外营养,全
黃疸,阻塞性%經皮經肝穿刺膽管引流%腸道營養%胃腸外營養,全
황달,조새성%경피경간천자담관인류%장도영양%위장외영양,전
jaundice,obstructive%percutaneous transhepatic cholangial drainage%enteral nutrition%parenteral nutrition,total
目的：探讨不同营养方式对恶性梗阻性黄疸患者经皮经肝穿刺胆管引流术（PTCD）后免疫功能的影响。方法将中国人民解放军第一八○医院2009年1月－2013年3月收治的50例恶性梗阻性黄疸患者根据入院先后顺序随机分为2组，每组各25例。A组患者PTCD术后接受肠内营养支持，B组患者PTCD术后接受全静脉营养支持，分别于术前1 d、术后7 d比较两组患者的退黄效果、营养状况以及机体免疫功能的变化。两组间比较采用t检验。结果50例接受PTCD术患者中39例引流效果理想，占78％，11例患者引流效果欠佳，占22％，其中A组5例（10％），B组6例（12％）。两种营养支持方法治疗后其营养指标明显高于治疗前，差异均有统计学意义（P＜0．05），但A组与B组治疗后各指标差异无统计学意义（P＞0．05）。通过PTCD以及营养支持治疗后两组患者的免疫功能均得到提升，与治疗前比较差异均有统计学意义（P＜0．05），但A组与B组之间的免疫功能差异无统计学意义（P＞0．05）；11例患者经过PTCD术后退黄效果不明显，这部分患者的虽然也接受相同方案的营养支持治疗，其免疫能力的提升幅度较术后退黄效果好的患者小（P均＜0．05）。结论恶性梗阻性黄疸患者退黄效果与PTCD术密切相关，与何种途径的营养方式关系不明显。
目的：探討不同營養方式對噁性梗阻性黃疸患者經皮經肝穿刺膽管引流術（PTCD）後免疫功能的影響。方法將中國人民解放軍第一八○醫院2009年1月－2013年3月收治的50例噁性梗阻性黃疸患者根據入院先後順序隨機分為2組，每組各25例。A組患者PTCD術後接受腸內營養支持，B組患者PTCD術後接受全靜脈營養支持，分彆于術前1 d、術後7 d比較兩組患者的退黃效果、營養狀況以及機體免疫功能的變化。兩組間比較採用t檢驗。結果50例接受PTCD術患者中39例引流效果理想，佔78％，11例患者引流效果欠佳，佔22％，其中A組5例（10％），B組6例（12％）。兩種營養支持方法治療後其營養指標明顯高于治療前，差異均有統計學意義（P＜0．05），但A組與B組治療後各指標差異無統計學意義（P＞0．05）。通過PTCD以及營養支持治療後兩組患者的免疫功能均得到提升，與治療前比較差異均有統計學意義（P＜0．05），但A組與B組之間的免疫功能差異無統計學意義（P＞0．05）；11例患者經過PTCD術後退黃效果不明顯，這部分患者的雖然也接受相同方案的營養支持治療，其免疫能力的提升幅度較術後退黃效果好的患者小（P均＜0．05）。結論噁性梗阻性黃疸患者退黃效果與PTCD術密切相關，與何種途徑的營養方式關繫不明顯。
목적：탐토불동영양방식대악성경조성황달환자경피경간천자담관인류술（PTCD）후면역공능적영향。방법장중국인민해방군제일팔○의원2009년1월－2013년3월수치적50례악성경조성황달환자근거입원선후순서수궤분위2조，매조각25례。A조환자PTCD술후접수장내영양지지，B조환자PTCD술후접수전정맥영양지지，분별우술전1 d、술후7 d비교량조환자적퇴황효과、영양상황이급궤체면역공능적변화。량조간비교채용t검험。결과50례접수PTCD술환자중39례인류효과이상，점78％，11례환자인류효과흠가，점22％，기중A조5례（10％），B조6례（12％）。량충영양지지방법치료후기영양지표명현고우치료전，차이균유통계학의의（P＜0．05），단A조여B조치료후각지표차이무통계학의의（P＞0．05）。통과PTCD이급영양지지치료후량조환자적면역공능균득도제승，여치료전비교차이균유통계학의의（P＜0．05），단A조여B조지간적면역공능차이무통계학의의（P＞0．05）；11례환자경과PTCD술후퇴황효과불명현，저부분환자적수연야접수상동방안적영양지지치료，기면역능력적제승폭도교술후퇴황효과호적환자소（P균＜0．05）。결론악성경조성황달환자퇴황효과여PTCD술밀절상관，여하충도경적영양방식관계불명현。
Objective To investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD).Methods A total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admis-sion order.The patients in group A (n=25 )received enteral nutritional support after PTCD,and those in group B (n=25 )received total parenteral nutritional support after PTCD.Intra-group and inter-group comparisons were made in terms of jaundice clearance,nutritional indices,and body’s immune function on preoperative day 1 and postoperative day 7;comparison between the two groups was made by t test. Results Among the 50 patients who underwent PTCD,39 (78%)had good drainage,while 1 1 (22%)did not reach the expectation,of which,5 (10%)were in group A and 6 (12%)in group B.In both groups,the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1(P<0.05),but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P>0.05).The immune function of patients in both groups was significantly improved following PTCD and nutrition-al support (P<0.05),but there was no significant difference between the two groups (P>0.05).Although the same scheme of nutritional support was used,there were 1 1 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P<0.05).Conclusion Jaundice clearance is closely re-lated to PTCD in patients with malignant obstructive jaundice,but not markedly associated with the ways of nutritional support.
