低热量肠内营养支持疗法对原发性肝癌术后恢复的临床疗效观察

摘要

目的 研究低热量肠内营养支持治疗方式对原发性肝癌术后恢复的临床疗效. 方法 回顾性分析笔者医院收治的接受肝切除术或肝局部切除术的患者120例,根据营养支持治疗方式不同分为低热量肠外营养组( HPN)和低热量肠内营养组(HEN),每组各60例. 对比两组患者的肝功能指标(TBIL、ALT、AST)以及营养指标(ALB、PCHE、PA),免疫功能(CD4+T 细胞、CD8 +T细胞、CD4+T细胞/CD8 +T细胞比值)、胃肠道功能(术后肠道通气时间)、并发症发生率以及至出院时营养支持费用和住院时间的差异. 结果 与低热量肠外营养组相比,低热量肠内营养组患者TBIL、ALT、AST明显较低,低热量肠内营养组患者ALB、PCHE、PA明显较高,低热量肠内营养组患者的CD4 +T细胞、CD8 +T细胞、CD4 +T细胞/CD8+T细胞比值均明显较高,低热量肠内营养组患者的胃肠道功能恢复情况、并发症发生率以及住院期间营养支持费用等均优于低热量肠外营养组,差异均有统计学意义(P<0.05). 结论 对于原发性肝癌术后患者,低热量肠外营养和低热量肠内营养支持疗法均有显著的疗效,但与低热量肠外营养疗法相比,低热量肠内营养支持疗法有显著优势,临床疗效更佳,值得临床推广应用.%Objective To study the clinical efficacy of low -calorie enteral nutrition support therapy for postoperative recovery in patients with primary hepatic carcinoma .Methods Retrospective analysis was performed in this study .120 patients, including partial liver or local liver resection , were divided into Hypocaloric parenteral nutrition group ( HPN) and Hypocaloric parenteral nutrition group ( HEN) by different nutritional treatment ways with each group of 60 case.Liver function ( TBIL, ALT, AST ) , nutrition indicators (ALB, PCHE, PA), immune function (CD4 +T cells, CD8 +T cells, CD4 +T cells/CD8 +T cell ratio), gastrointestinal tract function ( postoperative intestinal ventilation ) , the incidence of complications and nutritional support costs and hospitalization time difference were compared between two groups .Results Compared with the low -calorie parenteral nutrition group , TBIL, ALT, AST were significantly lower on low calorie enteral nutrition group (P<0.05); ALB, PCHE, PA, ALB, PCHE, PA, CD4 +T cells, CD8 +T cells, CD4 +T cells/CD8 +T cell ratio were significantly higher on low calorie enteral nutrition group ( P<0.05);low-calorie gastrointestinal function recovery, incidence of complications during hospitalization and nutritional support costs on enteral nutrition group were superior to low -calorie parenteral nutrition group .Moreover, the differences were statistical significance (P<0.05).Conclusion For postoperative pa-tients with primary hepatic carcinoma , both enteral and parenteral nutrition support therapies have significant effect , however ,enteral nu-trition therapy has more advantages , better clinical efficacy by comparing to parenteral nutrition therapy .Therefore, it is worthy of apply-ing in clinic .