中长链脂肪乳对结直肠肿瘤患者术后胃肠功能、血清蛋白质和细胞因子水平的影响
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摘要
目的探讨中长链脂肪乳对结直肠肿瘤患者术后胃肠功能、血清蛋白质和细胞因子水平的影响。方法采用随机数字表法将104例结直肠肿瘤术后患者分为对照组和治疗组各52例,对照组术后24h内补充普通长链脂肪乳9d;治疗组术后24h开始补充中长链脂肪乳9d,对比分析两组患者术后的胃肠功能、腹胀程度、血清蛋白质及细胞因子水平。结果治疗组患者术后胃肠功能较对照组明显改善,其肛门排气时间、首次排便时间、首次进食固体食物时间、肠鸣音正常时间明显短于对照组,差异均有统计学意义(P<0.05);两组患者术后腹胀程度比较,治疗组较对照组轻,差异有统计学意义(P<0.05);治疗组患者术后1、10d血清总蛋白、转铁蛋白、前清蛋白、清蛋白水平均明显高于术前,差异均有统计学意义(P<0.05),且同一时间段组间比较,治疗组升高程度较对照组更明显,差异均有统计学意义(P<0.05);治疗组患者术后1、3d血清降钙素原水平明显降低,且同一时间段组间比较,治疗组降低程度较对照组更明显,差异均有统计学意义(P<0.05);两组患者术后1d血清白细胞介素-8、白细胞介素-10、肿瘤坏死因子-α水平均明显高于术前,差异有统计学意义(P<0.05),而术后3d三者水平均明显低于术后1d,差异有统计学意义(P<0.05),术后3d组间比较,治疗组降低程度较对照组更明显,差异均有统计学意义(P<0.05)。结论中长链脂肪乳利于手术后患者胃肠功能恢复,有助于减轻腹胀,改善患者术后营养代谢,降低患者术后炎性反应。
Objective To investigate the effect of medium and long chain fatty emulsion(Baxter)on gastrointestinal function,serum protein and cytokine levels in patients with colorectal cancer after operation.Methods A total of 104 patients after colorectal cancer operation were divided into control group(n=52)and treatment group(n=52).The control group underwent with supplement ordinary long-chain fat emulsion and the treatment group were supplemented with medium and long chain fatty emulsion for 9 d;the gastrointestinal function,abdominal distension,serum protein and cytokine levels of two groups were analyzed.Results The postoperative gastrointestinal function of the treatment group was better than that of the control group,the anus exhaust time,the first defecation time,the first time to eat solid food,and the normal time of bowel sounds of the treatment group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05);the degree of abdominal distension in the treatment group was lighter than that in the control group,and the differences were statistically significant(P<0.05);the serum total protein,transferrin,prealbumin and albumin levels in the treatment group were significantly higher than those before operation at 1 and 10 dafter operation,and the difference was statistically significant(P<0.05),and during the same period,the increase degrees of those levels in the treatment group were higher than those in the control group,and the difference was statistically significant(P<0.05);the serum procalcitonin levels in the treatment group decreased significantly at 1 and 3 dafter operation,and during the same period of time,the decrease degree in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05);the levels of serum interleukin-8,interleukin-10 and tumor necrosis factor-αin the two groups at 1 dafter operation were significantly higher than those before operation,and the differences were statistically significant(P<0.05),while the levels at 3 dafter operation were significantly lower than those at 1 dafter operation,and the difference was statistically significant(P<0.05),in the comparison of the levels at 3 dafter operation,the decrease degree in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The medium and long chain fat emulsion is beneficial for gastrointestinal function recovery after surgery.It can help reduce abdominal distension,improve postoperative nutrition metabolism,and reduce postoperative inflammatory response.
Objective To investigate the effect of medium and long chain fatty emulsion(Baxter)on gastrointestinal function,serum protein and cytokine levels in patients with colorectal cancer after operation.Methods A total of 104 patients after colorectal cancer operation were divided into control group(n=52)and treatment group(n=52).The control group underwent with supplement ordinary long-chain fat emulsion and the treatment group were supplemented with medium and long chain fatty emulsion for 9 d;the gastrointestinal function,abdominal distension,serum protein and cytokine levels of two groups were analyzed.Results The postoperative gastrointestinal function of the treatment group was better than that of the control group,the anus exhaust time,the first defecation time,the first time to eat solid food,and the normal time of bowel sounds of the treatment group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05);the degree of abdominal distension in the treatment group was lighter than that in the control group,and the differences were statistically significant(P<0.05);the serum total protein,transferrin,prealbumin and albumin levels in the treatment group were significantly higher than those before operation at 1 and 10 dafter operation,and the difference was statistically significant(P<0.05),and during the same period,the increase degrees of those levels in the treatment group were higher than those in the control group,and the difference was statistically significant(P<0.05);the serum procalcitonin levels in the treatment group decreased significantly at 1 and 3 dafter operation,and during the same period of time,the decrease degree in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05);the levels of serum interleukin-8,interleukin-10 and tumor necrosis factor-αin the two groups at 1 dafter operation were significantly higher than those before operation,and the differences were statistically significant(P<0.05),while the levels at 3 dafter operation were significantly lower than those at 1 dafter operation,and the difference was statistically significant(P<0.05),in the comparison of the levels at 3 dafter operation,the decrease degree in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The medium and long chain fat emulsion is beneficial for gastrointestinal function recovery after surgery.It can help reduce abdominal distension,improve postoperative nutrition metabolism,and reduce postoperative inflammatory response.
引文
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[12]蒋宁.中长链脂肪乳营养在改善胃癌手术患者免疫功能和营养状况的研究[J/CD].中华普通外科学文献(电子版),2015,9(5):365-368.
[13]慕月晶,王伟佳,严海忠,等.PCT检测在全身和局部细菌感染诊断中的临床应用[J].检验医学,2015,30(1):17-20.
[14]丁海涛,帕尔哈提·阿布都热衣木,韩智君,等.结直肠癌NOSE术对患者氧化应激、免疫功能及机体微炎症的影响[J].中国现代手术学杂志,2017,21(1):9-13.
[15]魏静波,刘辉,朱小茼,等.IL-10、IL-12在结直肠癌中的表达及意义[J].现代预防医学,2014,41(16):3014-3016.
[16]杨勇,田敏.结直肠癌患者TNF-α、IL-6、IL-8水平与临床分期的关系与研究[J].标记免疫分析与临床,2016,23(7):790-793.
[17]黄文辉,林龙,黎明.胃肠外科肠外营养支持治疗中应用多种油脂肪乳对肝功能及相关炎性因子的影响[J].疑难病杂志,2017,16(3):259-262.
[2]CHEN S T,LEE T Y,TSAI T H,et al.The traditional chinese medicine DangguiBuxue Tang sensitizes colorectal cancer cells to chemoradiotherapy[J].Molecules,2016,21(12):e1677.
[3]VATHER R,TRIVEDI S,BISSETT I.Defining postoperative ileus:results of a systematic review and global survey[J].J Gastrointest Surg,2013,17(5):962-972.
[4]LIU M Y,WANG C W,WU Z P,et al.Electroacupuncture for the prevention of postoperative gastrointestinal dysfunction in patients undergoing vascular surgery under general anesthesia:study protocol for a prospective practical randomized controlled trial[J].J Integr Med,2014,12(6):512-519.
[5]OKAMURA A,TAKEUCHI H,MATSUDA S,et al.Factors affecting cytokine change after esophagectomy for esophageal cancer[J].Ann Surg Oncol,2015,22(9):1-6.
[6]莫黎,何永恒,康安定,等.枳实通降颗粒对结直肠肿瘤患者术后胃肠功能恢复及术后早期炎性肠梗阻防治作用的双中心前瞻性研究[J].中医杂志,2017,58(20):1760-1763.
[7]张国才,曾富春.不同食管癌根治术对患者术后肺功能、炎症因子及应激反应的影响[J].海南医学院学报,2016,22(16):1914-1917.
[8]中华人民共和国卫生和计划生育委员会医政医管局.结直肠癌诊疗规范(2015年版)[J].中华外科杂志,2015,53(12):881-894.
[9]王杉.外科与普通外科诊疗常规[M].北京:中国医药科技出版社,2013:154.
[10]MENG Z Q,GARCIA M K,CHIANG J S,et al.Electroacupuncture toprevent prolonged postoperative ileus:a randomized clinical trial[J].World J Gastroenterol,2010,16(1):104-111.
[11]胡潇云,秦桂英,邱隆敏,等.结直肠手术SSI预防与控制的研究进展[J].中华医院感染学杂志,2017,27(9):2156-2160.
[12]蒋宁.中长链脂肪乳营养在改善胃癌手术患者免疫功能和营养状况的研究[J/CD].中华普通外科学文献(电子版),2015,9(5):365-368.
[13]慕月晶,王伟佳,严海忠,等.PCT检测在全身和局部细菌感染诊断中的临床应用[J].检验医学,2015,30(1):17-20.
[14]丁海涛,帕尔哈提·阿布都热衣木,韩智君,等.结直肠癌NOSE术对患者氧化应激、免疫功能及机体微炎症的影响[J].中国现代手术学杂志,2017,21(1):9-13.
[15]魏静波,刘辉,朱小茼,等.IL-10、IL-12在结直肠癌中的表达及意义[J].现代预防医学,2014,41(16):3014-3016.
[16]杨勇,田敏.结直肠癌患者TNF-α、IL-6、IL-8水平与临床分期的关系与研究[J].标记免疫分析与临床,2016,23(7):790-793.
[17]黄文辉,林龙,黎明.胃肠外科肠外营养支持治疗中应用多种油脂肪乳对肝功能及相关炎性因子的影响[J].疑难病杂志,2017,16(3):259-262.