早期肠内营养联合免疫微生态支持对肝癌肝切除患者的影响

目的探讨早期肠内营养联合肠内免疫微生态营养（EIN）对肝癌肝切除患者术后早期肝功能及肠道功能的影响。方法将80例肝癌肝切除患者随机进入EIN组和肠外营养（PN）组。比较两组患者术后1、3、7d的血白细胞计数、谷丙转氨酶（ALT）、总胆红素（TBIL）、白蛋白补充量、血浆内毒素及术后7d内肠道排气时间及大便球杆比异常率。结果EIN组和PN组患者术后血白细胞计数变化差异无统计学意义，而术后第7天，EIN组患者ALT、TBIL恢复优于PN组，血浆白蛋白补充量少于PN组；肠道恢复时间早于PN组，同时大便球杆比异常率较PN组低（P〈0．05）。结论肝癌肝切除术患者早期实施肠内营养联合肠内免疫微生态支持治疗可以补充肠道正常菌群，减少细菌易位，减少内毒素血症及炎症因子的发生，有利于肝切除患者术后肝功能的恢复。

Effects of combining early enteral nutrition and immunonutrition on liver function and gut function in the hepatoma patients receiving hepatectomy

Objective To approach the effects of combining early enteral nutritioning with immunonutrition（EIN） on the liver function and gut function in the hepatoma patients receiving hepatectomy. Methods Eighty patients who received hepatectomy were randomly assigned to EIN group and parenteral nutrition （PN） group right after operation. At the 1st, 3rd and 7th day after operation, the peripheral white blood cells, ALT, TBIL, the supplement of albumin, plasma endotoxi, postoperation exhaust time and the abnormal rate of fecal microflora were measured. Results There was no significant difference in peripheral white blood ceils between the two groups. The patients in EIN group had a better recovery of ALT and TBIL, the plasma endotoxi and the fecal microflora abnormal rate was lower than those in PN group. Conclusion Therapy of combining early enteral nutrition with immunonutrition has favorable benefit on liver function and gut function than PN therapy, and therefore can quicken the recovery in the hepatoma patients receiving hepateetomy.