CAJ | 학술논문

目的：研究国产高能型肠内营养对大肠癌患者术后营养状况、炎性反应和免疫功能的影响。方法采用随机数表法将63例限期手术大肠癌患者分为研究组（n＝31）和对照组（n＝32），两组根据理想体重给予等热量104．5 kJ／kg· d和等氮量0．2 g／kg· d的肠内营养聚合剂，研究组给予高能型肠内营养（力存），对照组给予肠营养聚合剂（能全力），试验期为7天。观察基础人口学资料及临床信息，于术前和术后第7天检测患者营养状况、炎性反应和免疫功能。结果两种肠内营养均能同等改善大肠癌患者术后营养不良，两组血浆白蛋白（ ALB）、前白蛋白（ TP）、转铁蛋白（ FP）水平均高于术前。术后第7天，研究组CD4／CD8比值明显高于对照组及术前的，而血液IL-1、TNF-α水平和CRP水平明显低于对照组与术前的。术后第7天CD4、CD8水平与对照组及术前比较，无显著性意义。两组患者血尿素氮（BUN）、血总胆固醇（TC）、血甘油三酯（TG）各参数比较差别无显著性意义（P均＞0．05）。结论国产高能型肠内营养（力存）明显改善大肠癌患者营养不良，降低患者炎性反应和提高细胞免疫应答。
목적：연구국산고능형장내영양대대장암환자술후영양상황、염성반응화면역공능적영향。방법채용수궤수표법장63례한기수술대장암환자분위연구조（n＝31）화대조조（n＝32），량조근거이상체중급여등열량104．5 kJ／kg· d화등담량0．2 g／kg· d적장내영양취합제，연구조급여고능형장내영양（력존），대조조급여장영양취합제（능전력），시험기위7천。관찰기출인구학자료급림상신식，우술전화술후제7천검측환자영양상황、염성반응화면역공능。결과량충장내영양균능동등개선대장암환자술후영양불량，량조혈장백단백（ ALB）、전백단백（ TP）、전철단백（ FP）수평균고우술전。술후제7천，연구조CD4／CD8비치명현고우대조조급술전적，이혈액IL-1、TNF-α수평화CRP수평명현저우대조조여술전적。술후제7천CD4、CD8수평여대조조급술전비교，무현저성의의。량조환자혈뇨소담（BUN）、혈총담고순（TC）、혈감유삼지（TG）각삼수비교차별무현저성의의（P균＞0．05）。결론국산고능형장내영양（력존）명현개선대장암환자영양불량，강저환자염성반응화제고세포면역응답。
Objective To study the effect of hight energy enteral nutrition on postoperative nutritional status,inflammato-ry reaction and immune function of colorectal cancer.Methods According to random number table,63 colorectal cancer patients of limited operation were divided into the research group(n=31) and the control group(n=32),the 2 groups were given enteral nutrition polymerizer 104.5 kJ/kg · d and nitrogen is 0.2 g/kg· d according to the ideal weight,the research group received tumor special enteral nutrition(revilife),the control group received whole protein enteral nutrition(Nutrison Fibre),trial period was 7 days.Basic demographic data and clinical information of patients were observed,and the nutritional status,inflammatory re-action and immune function 7 days before and after surgery were detected.Results Both of the 2 types of the enteral nutrition could equally improve the malnutrition of colorectal tumor patients.The level of plasma albumin(ALB),prealbumin(TP),trans-ferrin( FP) of the 2 groups were higher than before the operation.On the 7th day after surgery,the team CD4 /CD8 ratio was sig-nificantly higher than that of the control group and before surgery,IL -1 and TNF alpha level and blood CRP levels are signifi-cantly lower than the control group and before surgery.On the 7th day after surgery,there was no significant difference on the com-parison of CD4,CD8 levels,the control group and before surgery.There was no significant difference on the 2 groups of patients in body weight,BMI,nutritional risk score,operation method,enteral nutrition,enteral nutrition,start time,serum creatinine(Cr), blood urea nitrogen(BUN),blood blood total cholesterol(TC),triglyceride(TG)(P>0.05).Conclusion Domestic hight ener-gy enteral nutrition(Revilife) can significantly improve malnutrition,reduce level of inflammatory factor and promote the tumor growth ability,improve the cellular immune responses.