微生态肠内营养在结直肠癌患者围手术期应用.docVIP

微生态肠内营养在结直肠癌患者围手术期应用 　【摘要】 　　目的：探讨微生态肠内营养在结直肠癌患者围手术期应用中的疗效。方法：将 90例结直肠癌患者随机分为3组：常规治疗组（RT）、肠内营养组（EN）及添加微生态制剂肠内营养组（EMN）。观察患者术中肠道清洁度以及术后排气时间、吻合口漏、感染情况以及菌群失调情况，并监测手术前后内毒素、CRP、TNF水平变化及淋巴细胞计数改变。结果： 术后排气时间EN组及MEN组均早于RT组（Plt;0.05），而EMN组早于EN组（Plt;0.05）；第1次排便后细菌油镜计数结果示 EN组及MEN组均明显低于RT组（Plt;0.05）,而EMN组低于EN组（Plt;0.05）。术后外周血内毒素及CRP水平EN组及MEN组均低于RT组（Plt;0.05），而EMN组低于EN组（Plt;0.05）；外周血淋巴细胞计数EMN组较术前有所增加（Plt;0.05）,其他两组无明显变化；TNF水平各组均高于术前水平（Plt;0.05）。肠腔清洁度、吻合口漏、切口感染率及腹腔感染率差异均无统计学意义（P＞0.05）。结论：添加微生态制剂肠内营养能有效防治患者肠道菌群失调，增强机体免疫力，促进肠道功能恢复。 【关键词】 结直肠癌　微生态肠内营养　菌群失调　免疫力 　　 Clinic application of enteral microecopharmaceutics nutrition in the perioperation of colorectal cancer 【ABSTRACT】 Objective: To investigate and evaluate the clinical effect of enteral microecopharmaceutics nutrition in the perioperative of patients with colorectal cancer. Methods: 90 patients with colorectal cancer were randomly divided three groups:the routine treatment （RT） group， the enteral nutrition （EN） group and the enteral microecopharmaceutics nutrition （EMN）group. To observe the entreo-cleaness in operation and the time of deflation,stomal leak,the conditions of infection and dysbacteriosis after operation and monitor the changes of endotoxin, CRP, TNF and the number of lymphocyte in serum befor and afer operation. Results: After operation, the time of deflation in the EN and EMN group were earlier than the RT group （Plt;0.05）,and the EMN group was earlier than the EN group（Plt;0.05）. The bacterium counted by immersion objective after the primary defecation in the EN and EMN group were markedly less than that in the RT group（Plt;0.05）, and the EMN group was less than the EN group（Plt;0.05）.In addition, the level of endotoxin and CRP in serum markedly decreased in the EN and EMN group compared with the EN group（Plt;0.05）, and the EMN group was less than the EN group（Plt;0.05）;the number of lymphocyte in serum increased after operation in the EMN group （Plt;0.05）, and the others have not significant alteration; the