老年肝癌患者肝癌切除术后早期肠内营养支持治疗的临床价值

目的探讨老年肝癌患者肝癌切除术后早期肠内营养支持治疗的临床价值。方法将接受肝癌切除术治疗的76例老年肝癌患者随机分为观察组（38例）与对照组（38例），观察组患者术后早期接受肠内营养治疗，对照组患者术后接受肠外营养治疗。结果①手术前，2组患者总胆红素（TBIL）、丙氨酸氨基转移酶（AIJT）、白蛋白（ALB）、拟胆碱酯酶（PCHE）、前白蛋白（PA）相比差异无统计学意义（P〉0．05）。手术后第7天，观察组TBIL、ALT显著低于对照组，ALB、PCHE、PA显著高于对照组（P〈0．05）。②手术前，两组患者CD4＋T细胞、CD8＋T细胞、CD4＋T细胞／CD8＋T细胞比值相比，差异无统计学意义（P〉0．05）。手术后第7天，观察组上述指标显著高于对照组（P〈0．05）。③观察组术后肺部感染、胆瘘发生率显著低于对照组（P〈0．05）。结论术后早期肠内营养支持治疗可以显著改善老年肝癌患者肝癌切除术后的营养状况及免疫力，降低并发症发生率。

Clinical Value of Early Postoperative Enteral Nutrition for Elderly Hepatocellular Carcinoma Patients after Liver Resection

Objective To explore the clinical value of early postoperative enteral nutrition in elderly patients with hepa- tocellular carcinoma after liver resection. Methods 76 cases of elderly patients with hepatocellular carcinoma who received liver resection were randomly divided into the observation group（ 38 cases） and the control group（ 38 cases） , and the observation group was given early postoperative enteral nutrition,while the control group received parenteral nutrition. Results ①Before surgery, there were no significant differences in total bilirubin（TBIL） , alanine aminotransferase（ALT） , albumin （ALB） , pseudocholinesterase （ PCHE ）, pre-albumin （PA） between the 2 groups （ P 〉 0.05 ）. On the 7th day after surgery, TBIL and ALT of the observation group were significantly lower than those of the control group （P 〈 0.05 ）, while the ALB, PCHE and PA of the observation group were significantly higher than those of the control group （P 〈 0.05 ）. ②Before surgery, there were no significant differences in the CD4＋ T-cells, CD8 ＋ T-cells, ratio of CD4 ＋ T-cells/CD8 ＋ T-cells between the 2 groups （ P 〉 0.05 ）. On the 7th day after surgery, the afore-mentioned indexes of the observation group were significantly higher than those of the control group（ P 〈 0.05 ）. ③The incidence rates of postoperative pulmonary infection and biliary fistula of the observation group were significantly lower than those of the control group（ P 〈 0.05 ）. Conclusion The early postoperative enteral nutrition can significantly improve the nutritional status and immunity of elderly patients with hepatocellular carcinoma after liver resection, and reduce the incidence of complications.