【摘要】：目的:觀察術(shù)前給予腸內(nèi)營(yíng)養(yǎng)支持后,對(duì)于有營(yíng)養(yǎng)風(fēng)險(xiǎn)的老年結(jié)直腸癌患者在接受手術(shù)治療后的營(yíng)養(yǎng)狀態(tài)、免疫功能和并發(fā)癥的情況。方法:運(yùn)用NRS2002營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查標(biāo)準(zhǔn),選擇出我院70例老年結(jié)直腸癌且合并有營(yíng)養(yǎng)風(fēng)險(xiǎn)的患者,隨機(jī)分為腸內(nèi)營(yíng)養(yǎng)組(EN組)36例,對(duì)照組34例。腸內(nèi)營(yíng)養(yǎng)組術(shù)前3天給予腸內(nèi)營(yíng)養(yǎng)支持,在接受手術(shù)治療后第1、3、5、7天檢測(cè)血漿總蛋白、前清蛋白、清蛋白、轉(zhuǎn)鐵蛋白、淋巴細(xì)胞總數(shù)、血漿D-乳酸(D-lactic acid,D-LAC)和二胺氧化酶(diamine oxidase,DAO),觀察術(shù)中腸道清潔度、術(shù)后并發(fā)癥。結(jié)果:在術(shù)后第1、3、5、7天的血漿總蛋白、前清蛋白、清蛋白、轉(zhuǎn)鐵蛋白及淋巴細(xì)胞總數(shù)的比較中,腸內(nèi)營(yíng)養(yǎng)組均明顯高于對(duì)照組;D-LAC、DAO水平及腹腔感染、傷口感染等感染性并發(fā)癥的發(fā)生率顯著低于對(duì)照組,兩組差異有統(tǒng)計(jì)學(xué)意義;兩組在腸道清潔度、吻合口漏發(fā)生率上,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:老年結(jié)直腸癌合并營(yíng)養(yǎng)風(fēng)險(xiǎn)時(shí),術(shù)前給予腸內(nèi)營(yíng)養(yǎng)支持,可顯著提高手術(shù)后的營(yíng)養(yǎng)狀態(tài)和免疫力,降低并發(fā)癥。
[Abstract]:Objective: to observe the nutritional status, immune function and complications of elderly colorectal cancer patients with nutritional risk after preoperative enteral nutrition support. Methods: 70 elderly colorectal cancer patients with nutritional risk were randomly divided into EN group (36 cases) and control group (34 cases). The enteral nutrition group was given enteral nutrition support 3 days before operation. Plasma total protein, prealbumin, transferrin, lymphocyte count and plasma D-lactic acid, were measured on the 1st day after operation. D-LAC) and diamine oxidase (diamine oxidase,DAO) were used to observe the intestinal cleanliness and postoperative complications. Results: in the comparison of plasma total protein, prealbumin, transferrin and lymphocyte count on the 7th day after operation, enteral nutrition group was significantly higher than the control group. The levels of D-LACU Dao and the incidence of infectious complications, such as intraperitoneal infection and wound infection, were significantly lower than those in the control group, and the difference between the two groups was statistically significant. There was no significant difference in intestinal cleanliness and anastomotic leakage between the two groups (P0.05). Conclusion: in elderly patients with colorectal cancer associated with nutritional risk, preoperative enteral nutrition support can significantly improve the nutritional status and immunity after surgery, and reduce complications.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.34

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