肝癌术后早期不同免疫增强型营养支持方式的治疗效果比较

目的 探讨肝癌术后采取早期免疫增强型肠内和早期免疫增强型肠外营养支持的治疗效果.方法 选择接受治疗的肝癌患者150例,分为1组48例、2组53例和3组49例,其中,1组给予早期免疫增强型肠内营养支持(EEN),2组给予早期免疫增强型肠外营养支持(EPN),3组给予EEN合用EPN.记录患者手术前后不同时间段的免疫相关指标、营养相关指标、肝功能相关指标以及预后相关指标.结果 所有患者在术后7 d的免疫指标较术后2 d均出现明显恢复,但3组中各指标明显高于1组和2组,恢复程度更高(P<0.05);所有患者在术后7 d的各营养指标明显高于术后2 d(P<0.05);3组在术后7 d的各营养指标明显高于1组和2组(P<0.05);所有患者在术后7 d的各肝功能相关指标均有所恢复,3组术后7 d的各项肝功能指标均明显优于1组和2组(P<0.05);3组治疗后的各种并发症发生、住院时间以及住院费用明显少于1组和2组,且3组的接受程度明显高于1组和2组(P<0.05).结论 EEN和EPN均能提高术后肝癌患者的免疫功能,营养状况以及预后恢复,但EEN合用EPN疗效更为显著、可靠,值得在临床上推广应用.

Comparative study on the therapeutic effects of different types medication of immune support therapy in patients with liver cancer after surgery

Objective To observe the therapeutic effects of early enteral nutrition (EEN) and early parenteral nutrition (EPN) on liver cancer after surgery.Methods One hundred and fifty patients with liver cancer who received surgical treatment in our hospital were randomly divided into threee groups,group 1 (n=48),group 2 (n=53) and group 3 (n=49).The patients in group 1 were treated by EEN,and the patients in group 2 were treated by EPN,however,the patients in group 3 were treated by EPN combined with EEN.The related indexes with immune,nutrition,liver function and prognosis in different time points before and after operation were observed and compared among the three groups.Results The immune-related indexes on 7 days after surgery were obviously improved in the three groups,as compared with those on 2 days after surgery,but these indexes in group 3 were superior to those in group 1 and group 2 (P<0.05).The nutrition-related indexes on 7 days after surgery were obviously improved in the three groups,as compared with those on 2 days after surgery (P<0.05),however, these indexes in group 3 were superior to those in group 1 and group 2 (P<0.05).The liver function-related indexes on 7 days after surgery were improved in the three groups,however, these indexes in group 3 were superior to those in group 1 and group 2 (P<0.05).Moreover the incidence rate of complications,length of staying in hospital and hospital costs in group 3 were significantly less than those in group 1 and group 2,furthermore, the acceptance degree in group 3 was significantly higher than that in group 1 and group 2 (P<0.05).Conclusion Both EEN and EPN can improve immune function,nutritional status and prognosis in patients with liver cancer after surgery,but the therapeutic effects of EEN combined with EPN are more obvious and more reliable, therefor, which is worth using widely in clinical practice.