[1]于敏.早期肠内营养对肝细胞癌患者术后肝功能与胃肠功能的影响[J].陕西医学杂志,2018,(11):1430-1433.
　Yu Min..Effects of early enteral nutrition on hepatic and gastrointestinal rehabilitation after hepatectomy in patients with hepatocellular carcinoma[J].,2018,(11):1430-1433.
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早期肠内营养对肝细胞癌患者术后肝功能与胃肠功能的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2018年11期
页码:
1430-1433
栏目:
临床研究
出版日期:
2018-11-29

文章信息/Info

Title:
Effects of early enteral nutrition on hepatic and gastrointestinal rehabilitation after hepatectomy in patients with hepatocellular carcinoma
文章编号:
0.3969/j.issn.1000-7377.2018.11.019
作者:
于敏
锦州医科大学附属第三医院普外科（锦州121000）
Author(s):
Yu Min.
General Surgery, the Third Hospital Affiliated to Jinzhou Medical University（Jinzhou 121000）
关键词:
癌;  肝细胞肠道营养肝功能试验胃肠道
Keywords:
Carcinoma;  hepatocellularEnteral nutritionLiver function testsGastrointestinal tract
分类号:
R735.7
文献标志码:
A
摘要:
目的：探讨早期肠内营养对肝细胞癌（HCC）患者手术后肝脏与胃肠康复功能的影响。方法：HCC行外科手术治疗的患者72例为研究对象。采用随机数字表法将患者分为观察组和对照组，每组36例。观察组术后给予早期肠内营养支持治疗，对照组给予静脉营养支持治疗，疗程为7 d。术前、术后3 d和术后8 d，采集患者空腹静脉血，检测肝功能相关指标，包括：白蛋白（ALB）、总胆红素（TBIL）、丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）；检测前白蛋白 （PAB）、 血红蛋白 （Hb）、转铁蛋白（TRF）及外周血淋巴细胞计数 （TLC）；观察患者排气时间、排便时间、进食时间。结果：术前，两组ALB、TBIL、ALT和AST比较差异均无统计学意义（P＞0.05）。术后两组TBIL、ALT和AST均呈先上升后下降趋势，ALB呈先下降后上升趋势，术后3 d和术后8 d，两组ALB、ALT和AST比较差异均无统计学意义（P＞0.05）。术后8 d，观察组TBIL（17.5±6.0）μmol/L显著低于对照组的（22.5±6.8）μmol/L（P＜0.05）。术前、术后3 d和术后8 d，两组PAB、Hb、TRF及TLC比较差异均无统计学意义（P＞0.05）。观察组首次排气时间、首次排便时间和首次进食时间分别为（62.5±7.8）h、（73.2±22.5）h和（78.5±23.5）h，均显著低于对照组的（82.1±15.6）h、（98.9±26.8）h和（92.6±26.5）h（P＜0.05），两组胃肠道不良反应发生率比较差异无统计学意义（P＞0.05）。结论：早期肠内营养支持治疗可以促进HCC患者肝功能和胃肠道功能恢复，对HCC患者预后改善具有重要价值。
Abstract:
Objective：To investigate the effect of early enteral nutrition on hepatic and gastrointestinal rehabilitate in patients with hepatocellular carcinoma (HCC). Methods：Seventy-two patients undergoing surgical treatment of HCC were selected as study subjects. Patients were divided into observation group and control group using random number table method, with 36 cases in each group. The observation group was given early enteral nutrition support treatment after surgery, and the control group was given intravenous nutrition support treatment for 7 days. Preoperatively, 3 days after surgery and 8 days after operation, fasting venous blood was collected from the patient and liver function-related parameters including albumin (ALB), total bilirubin (TBIL), alanine aminotransferase (ALT), and aspartic acid were measured. Transaminase (AST); prealbumin (PAB), hemoglobin (Hb), transferrin (TRF), and peripheral blood lymphocyte counts (TLC) were measured; patient exhalation time, defecation time, and eating time were observed. Results Before operation, there was no significant difference in ALB, TBIL, ALT and AST between the two groups (P＞0.05). Both TBIL, ALT and AST showed a trend of first increase and then decrease, and ALB first decreased and then increased. Postoperatively 3 days and postoperative 8 days, there was no significant difference in ALB, ALT and AST between the two groups (P＞0.05). At 8 days after operation, TBIL (17.5±6.0) μmol/L was significantly lower in the observation group than in the control group (22.5±6.8) μmol/L (P＜0.05). There was no significant difference in PAB, Hb, TRF and TLC between preoperative, postoperative 3 days, and postoperative 8 days (P＞0.05). The first time of degassing, first defecation and first-time eating in the observation group were (62.5±7.8) h, (73.2±22.5) h and (78.5±23.5) h, respectively, which were significantly lower than the control group (82.1±15.6) h. (98.9±26.8)h and (92.6±26.5)h (P＜0.05). There was no significant difference in the incidence of gastrointestinal adverse reactions between the two groups (P＞0.05). Conclusion：Early enteral nutrition support therapy can promote the recovery of liver function and gastrointestinal function in patients with HCC, which is of great value for the prognosis of HCC patients undergoing hepatectomy.

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更新日期/Last Update: 2018-11-30