论文部分内容阅读
目的:探讨免疫营养素对恶性梗阻性黄疸患者胆道支架植入术后感染的发生情况及临床预后的影响。方法:选择2013年2月到2016年1月选择在我院诊治的恶性梗阻性黄疸患者156例,据入院顺序分为观察组与对照组各78例,两组均行PTCD~+胆道金属支架植入术,观察组入院当日开始给予免疫营养制剂(在普通低脂饮食基础上添加鱼油脂肪酸和复方谷氨酰胺肠溶胶囊)口服,对照组入院当日开始给予普通低脂饮食,两组均治疗5 d,观察两组预后情况。结果:两组术后15 d的CD4~+值都明显高于术后1 d(P<0.05),观察组术后15 d的CD4~+值也明显高于对照组(P<0.05),两组不同时间点的CD8~+值对比差异无统计学意义(P>0.05)。观察组与对照组术后15 d的血清IL-6和TNF-α值都明显低于术后1 d(P<0.05),观察组术后15 d的血清IL-6和TNF-α值也明显低于对照组(P<0.05)。观察组术后感染发生率为5.1%,明显低于对照组的20.5%(P<0.05)。结论:胆道支架植入术术前应用免疫营养素可改善恶性梗阻性黄疸患者的免疫功能,抑制炎症反应,从而减少感染的发生率,促进患者的康复。
Objective: To investigate the effect of immunonutrients on the occurrence and clinical prognosis of patients with malignant obstructive jaundice after biliary stenting. Methods: From February 2013 to January 2016, 156 patients with malignant obstructive jaundice who were selected for diagnosis and treatment in our hospital were selected and divided into observation group and control group according to admission sequence. 78 patients in each group were treated with PTCD ~ + biliary metal stent On the day of admission, immunosuppressive agents (supplemented with fish oil fatty acid and compound glutamine enteric-coated capsules) were given orally on the day of admission and the control group received ordinary low-fat diet on the day of admission, and both groups were treated 5 d, observe the two groups prognosis. Results: The CD4 ~ + values of the 15th postoperative day were significantly higher than those of the 1st postoperative day (P <0.05), and the CD4 ~ + values of the 15th postoperative day in the observation group were also significantly higher than those in the control group (P <0.05) There was no significant difference in CD8 ~ + values between two groups at different time points (P> 0.05). The serum levels of IL-6 and TNF-α in the observation group and the control group were significantly lower than those on the 15th day after operation (P <0.05), and the levels of IL-6 and TNF-α Significantly lower than the control group (P <0.05). The incidence of postoperative infection in the observation group was 5.1%, significantly lower than that of the control group (20.5%, P <0.05). Conclusion: The application of immunonutrient before biliary stent implantation can improve immune function and inhibit inflammatory reaction in patients with malignant obstructive jaundice, so as to reduce the incidence of infection and promote the recovery of patients.