| 王 瑛,袁鹤立,甄 珍.肠内营养剂对原发性肝癌术后免疫功能及炎症因子的影响[J].肿瘤学杂志,2019,25(7):641-645. |
| 肠内营养剂对原发性肝癌术后免疫功能及炎症因子的影响 |
| Effects of Immunologic Function and Inflammatory Factors of Enteral Nutrition Support in Patients with Liver Cancer After Hepatectomy |
| 投稿时间：2018-06-30 |
| DOI：10.11735/j.issn.1671-170X.2019.07.B011 |
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| 中文关键词: 肠内营养 肝切除术 肝癌 肝功能 炎症因子 |
| 英文关键词:enteral nutrition hepatectomy liver cancer liver function inflammatory factors |
| 基金项目:河北省医学科学研究重点课题计划项目（20181452） |
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| 中文摘要: |
| 摘 要：［目的］ 评估肠内营养剂支持治疗对行肝切除术的原发性肝癌患者肝功能、免疫功能及炎症因子的影响。［方法］ 2015年1月至2016年12月在我院接受肝切除手术的肝癌患者91例，观察组（42例）患者给予早期肠内营养，对照组（49例）患者给予传统术后饮食。［结果］ 两组患者术后3d时天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、白蛋白（ALB）、总胆红素（TBIL）及术后7d时AST、ALT水平比较差异均无统计学意义（P>0.05）。观察组术后7d时 ALB、TBIL水平与对照组比较差异均有统计学意义（P<0.05）；两组患者术后3d CD4、CD8、CD4/CD8水平比较差异均无统计学意义（P>0.05）。观察组术后7d CD4、CD8、CD4/CD8水平明显高于对照组（P<0.05）；两组患者术后3d时血清白细胞介素-1（IL-1）、血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平比较差异均无统计学意义（P>0.05）。观察组术后7d时 IL-1、IL-6、TNF-α水平明显低于对照组（P<0.05）。观察组的胃肠功能恢复时间、平均住院日及术后并发症均低于对照组（P<0.05）。两组患者术后1年生存率比较无统计学差异（P>0.05）。［结论］ 早期肠内营养支持治疗行肝切除术的原发性肝癌患者可以促进肝功能恢复，改善术后免疫抑制状态，降低体内炎症反应，可促进术后胃肠功能恢复、缩短住院日、减少术后并发症，对预后恢复具有一定的临床意义。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate effects of liver function，immunologic function and inflammatory factors in patients with liver cancer with hepatectomy by treatment of enteral nutrition support. ［Methods］ The clinical data of 91 patients with liver cancer undergoing liver resection in our hospital from January 2015 to December 2016 were analyzed. The observation group(42 patients) received early enteral nutrition，and the control group(49 patients) received liquid food and semiliquid food. ［Results］ The difference in the level of AST，ALT，ALB and TBIL at 3d after operation，and the difference in the level of AST and ALT at 7d after operation in two groups were not statistically significant(P>0.05). The ALB and TBIL levels in the observation group at 7d were statistically different from those in the control group(P<0.005). The levels CD4，CD8 and CD4/CD8 in the observation group were higher than those in the control group in 7d after the operation，and the difference was statistically significant(P<0.05). The levels of IL-1，IL-6 and TNF- in observation group were significantly lower than those in the control group at 7d after the operation(P<0.05). The gastrointestinal function recovery time，hospitalization days and postoperative complications in observation group were lower than those in control group(P<0.05). There was no difference in the 1 year survival rate between two groups(P>0.05). ［Conclusions］ Early enteral nutrition therapy can promote the recovery of liver function，improve the immunosuppressive status of patients after surgery，reduce the inflammation in the body. It can also promote postoperative gastrointestinal function recovery，shorten hospitalization days and reduce postoperative complications. It has important clinical significance in prognosis of patients with hepatocellular carcinoma underwent hepatectomy recovery. |
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