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目的:探讨口服肠内营养(EN)联合聚乙二醇对伴有不全肠梗阻的结直肠肿瘤病人行围手术期准备的可行性及疗效。方法:对结直肠癌伴有不全梗阻的病人分为两组,研究组(n=72)病人术前口服整蛋白型EN和聚乙二醇进行围手术期准备;对照组(n=105)病人术前给予流质饮食和冲服番泻叶行常规术前准备。观察两组病人术前营养评分、术中肠道清洁度、术后肛门首次排气时间、术后吻合口瘘、感染并发症、免疫指标以及血浆内毒素水平等。结果:研究组病人营养评分、肠道清洁度均好于对照组(P<0.05)。对照组病人感染并发症的发生率明显高于研究组。研究组病人术后第7天的Ig G、Ig M和CD3+、CD4+、CD8+、CD4+/CD8+水平较对照组高,术前1 d血浆内毒素含量低于对照组,两组比较均有显著性差异(P<0.05)。结论:整蛋白型EN制剂联合聚乙二醇在结直肠肿瘤伴不全肠梗阻病人围手术期中的应用,不仅术中肠道清洁度满意,而且还能改善病人术后营养和免疫功能,保护肠黏膜屏障,加速胃肠功能的恢复。
Objective: To investigate the feasibility and efficacy of oral enteral nutrition (EN) combined with polyethylene glycol (PEG) for perioperative preparation of colorectal cancer with incomplete intestinal obstruction. Methods: The patients with colorectal cancer with incomplete obstruction were divided into two groups. The study group (n = 72) was preoperatively orally administered with whole protein EN and polyethylene glycol for perioperative preparation. The control group (n = 105) The patient was given preoperative fluid diet and the senna line routine preoperative preparation. Preoperative nutritional score, intraoperative intestinal cleanliness, postoperative anal first exhaust time, postoperative anastomotic fistula, infection complications, immune indexes and plasma endotoxin levels were observed. Results: The nutritional score and intestinal cleanliness of the study group were better than those of the control group (P <0.05). The incidence of infection complications in the control group was significantly higher than that of the study group. Study Group postoperative day 7 Ig G, Ig M and CD3 +, CD4 +, CD8 +, CD4 + / CD8 + higher levels than the control group, the 1 d plasma preoperative endotoxin levels than the control group, the two groups were significantly Difference (P <0.05). Conclusion: The whole protein type EN preparations for the combination of polyethylene glycol in colorectal cancer patients with intestinal obstruction with incomplete applications perioperative period, not only satisfied with the cleanliness of the intestinal surgery, but also to improve postoperative nutrition and immune function, intestinal protection Mucosal barrier to speed up the recovery of gastrointestinal function.