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目的:比较两种营养支持方式在胃肠道肿瘤患者术后的疗效。方法:回顾性分析2009年4月至2012年11月在我院治疗的胃肠道肿瘤患者80例的临床资料,按数字随机分为两组,观察组(40例)给予早期肠内营养支持治疗,对照组(40例)给予肠外营养支持治疗,治疗7d,比较两组的治疗前后体重、前白蛋白、白蛋白、淋巴细胞总数及亚群构成情况,并记录两组治疗后情况。结果:两组治疗前体重、前白蛋白、白蛋白、淋巴细胞总数及亚群构成情况均无明显差异;治疗7d后,观察组体重(58.05±8.46)kg、前白蛋白(25.99±5.36)g/L、白蛋白(37.1±11.2)g/L,明显大于对照组的(53.12±12.37)kg、(22.96±4.37)g/L、(33.5±8.8)g/L,P<0.05;观察组淋巴细胞总数(1.22±0.32)×109/L、CD3+(60.28±10.56)%、CD4+(34.06±9.67)%、CD8+(25.76±5.98)%、CD4+/CD8+(1.50±0.65),明显大于对照组的(1.07±0.43)×109/L、(56.74±9.95)%、(31.08±8.06)%、(22.14±5.77)%、(1.39±0.72),P<0.05;观察组住院时间(9.9±2.4)d、排气时间(3.8±1.8)d、肠蠕动恢复时间(3.5±2.0)d、腹部不适发生率12.5%均明显小于对照组的(15.1±3.8)d、(6.1±1.9)d、(4.8±1.7)d、腹部不适发生率37.5%,P<0.05。结论:早期肠内营养支持能改善胃肠道肿瘤患者术后的营养状态,增强免疫抵御能力,改善肠功能,降低不良反应发生,有利于患者的预后。
Objective: To compare the efficacy of two nutritional support methods in patients with gastrointestinal cancer after surgery. Methods: The clinical data of 80 patients with gastrointestinal cancer treated in our hospital from April 2009 to November 2012 were retrospectively analyzed. The data were randomly divided into two groups according to the numbers. The patients in the observation group (40 patients) were given early enteral nutrition support The patients in control group (40 cases) were given parenteral nutrition support therapy for 7 days. The body weight, prealbumin, albumin, total lymphocyte count and subgroups were compared between the two groups before and after treatment. The post-treatment conditions were recorded. Results: There was no significant difference in body weight, prealbumin, albumin, total lymphocyte count and sub-group constitution before treatment. After 7 days of treatment, body weight (58.05 ± 8.46) kg, prealbumin (25.99 ± 5.36) (37.1 ± 11.2) g / L and (53.12 ± 12.37) kg and (22.96 ± 4.37) g / L and (33.5 ± 8.8) g / L respectively in the control group The total number of lymphocytes (1.22 ± 0.32) × 109 / L, CD3 + (60.28 ± 10.56)%, CD4 + (34.06 ± 9.67)%, CD8 + (25.76 ± 5.98)% and CD4 + / CD8 + (1.07 ± 0.43) × 109 / L, (56.74 ± 9.95)%, (31.08 ± 8.06)%, (22.14 ± 5.77)%, (1.39 ± 0.72) 2.4 ± d, 3.8 ± 1.8 d, 3.5 ± 2.0 d and 12.5% of abdominal discomfort were significantly lower than those in control group (15.1 ± 3.8 d, 6.1 ± 1.9 d , (4.8 ± 1.7) d, the incidence of abdominal discomfort was 37.5%, P <0.05. Conclusion: The early enteral nutrition support can improve the nutritional status of patients with gastrointestinal cancer after operation, enhance the immune defenses, improve intestinal function and reduce the adverse reactions, which is in favor of the patients’ prognosis.