文章摘要
纪俊标,陈 涛,徐 皓,华一兵.应用肠内免疫营养与生态营养对胃癌术后患者营养支持疗效的前瞻?随机?对照临床研究[J].南京医科大学学报,2009,29(3):338~344
应用肠内免疫营养与生态营养对胃癌术后患者营养支持疗效的前瞻?随机?对照临床研究
Effects of postoperative immue-enhancing enteral nutrients and probiotics on metabolic and immunologic status in patients undergoing radical gastrectomy surgery: a randomized, controlled trial
投稿时间:2008-08-13  
DOI:10.7655
中文关键词: 胃癌  肠内免疫营养  生态营养  免疫
英文关键词: gastric cancer  immue-enhancing enteral nutrients  microecopharmaceutics nutrition  immunization
基金项目:江苏省卫生厅兴卫工程[苏卫规材(2007)158]
作者单位
纪俊标 南京医科大学第一附属医院普外科,江苏 南京 210029 
陈 涛  
徐 皓  
华一兵  
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中文摘要:
      目的:探讨肠内免疫营养与生态营养对胃癌术后患者营养状态和免疫水平的影响?方法:将60例胃癌患者双盲?随机分为普通肠内营养组(enteral nutrition,EN组,15例)?普通肠内营养+生态营养组(enteral microeco-pharmaceutics nutrition,EMN组,15例)?肠内免疫营养组(immue-enhancing enteral nutrients,EIN组,15例)?肠内免疫营养组+生态营养组(enteral microecopharmaceutics immunonutrition,EMIN组,15例),比较4组患者的术后营养状况?免疫功能?氮平衡以及菌群失调情况?结果:EIN组与EN组相比,EIN组能提高术后IgG?IgA水平,减少肠管内大肠杆菌?球杆菌含量,增高双歧杆菌?乳杆菌含量(P < 0.05),EMN组与EN组相比,EMN组能提高术后IgG?IgA水平,减少肠管内大肠杆菌?球杆菌含量,增高双歧杆菌?乳杆菌含量(P < 0.05),EMIN组与EN组相比,EMIN组能提高术后总蛋白?白蛋白?前白蛋白?IgG?IgA,IgM?CD3?CD4以及CD4/CD8水平,加速纠正负氮平衡,减少肠管内大肠杆菌?球杆菌含量,增高双歧杆菌?乳杆菌含量(P < 0.05),EMIN组与EMN组?EIN组相比,EMIN组术后总蛋白?白蛋白?前白蛋白?IgG?IgA,IgM?CD3?CD4以及CD4/CD8水平?氮平衡指数,肠管内双歧杆菌?乳杆菌含量明显高于EMN组?EIN组,肠管内大肠杆菌?球杆菌含量明显低于EMN组?EIN组(P < 0.05)?EN组?EIN组以及EMN组的术后总蛋白?白蛋白?前白蛋白?IgM?CD3?CD4?CD4/CD8水平以及净氮平衡指数差异无统计学意义(P > 0.05)?结论:胃癌术后,联合应用肠内免疫营养与生态营养对胃癌术后患者营养支持,与单独使用肠内免疫营养或者生态营养相比,能更好的促进患者蛋白质合成?免疫功能恢复?纠正负氮平衡以及肠道菌群失衡?
英文摘要:
      Objective:To explore the effect of immue-enhancing enteral nutrients together with enteral microeco-pharmaceutics nutrition in patients undergoing radical gastrectomy surgery. Methods:Sixty gastric cancer patients were randomly divided into EN group(n = 15), EMN group(n = 15), EIN group(n = 15), and EMIN group(n = 15). Nitrogen balance, nutritional status, immune function, exhaust time and intestinal flora status were compared among the 4 groups. Results:The level of IgG, IgA and the quantity of Bacillus bifidus and Bacterium lacticum in intestinal canal is much higher in EIN group compare with those in EN group(P < 0.05). The level of the quantity of Bacillus coli and coccobacillus is much lower in EIN group compare with that in EN group in patients undergoing radical gastrectomy surgery(P < 0.05). The level of IgG, IgA and the quantity of Bacillus bifidus and Bacterium lacticum in intestinal canal is much higer in EMN group compare with that in EN group(P < 0.05). The level of the quantity of Bacillus coli and coccobacillus is much lower in EMN group compare with that in EN group in patients undergoing radical gastrectomy surgery(P < 0.05). The level of total protein, albumin, prealbumin, IgG, IgA, IgM, CD3, CD4, CD4/CD8, the nitrogen balance index and the quantity of Bacillus coli and coccobacillus in intestinal cana is muche higer in EMIN group compare with those in EN group(P < 0.05). The level of the quantity of Bacillus bifidus and Bacterium lacticum in intestinal canal is much lower in EMIN group compare with that in EN group in patients undergoing radical gastrectomy surgery(P < 0.05). The level of total protein, albumin, prealbumin, IgG, IgA, IgM, CD3, CD4 and CD4/CD8, nitrogen balance index, the quantity of Bacillus bifidus and Bacterium lacticum in intestinal canal in EMIN group, is much higher than than that in EMN and EIN groups while the quantity of Bacillus coli and coccobacillus in EMIN group is much lower than that in EMN and EIN groups in patients undergoing radical gastrectomy surgery(P < 0.05). The level of total protein, albumin, prealbumin, IgM, CD3, CD4, CD4/CD8, negative nitrogen balance index in EN group, EIN group and the group EMN three groups was no significant difference in patients undergoing radical gastrectomy surgery(P > 0.05). Conclusion:Supported by the combination of enteral microecopharmaceutics nutrition and immue-enhancing enteral nutrients in patients undergoing radical gastrectomy surgery, the level of metabolic and immunologic status is much higer, compared with the use of a separate intestinal immune eco-nutrition or microecopharmaceutics nutrition.
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