微生态肠内营养在胃肿瘤术后患者应用临床探究.docVIP

微生态肠内营养在胃肿瘤术后患者应用临床探究 　 作者：杨忠全，古松刚，严江，谢舜峰，刘玩燕，许建衡 【关键词】 胃肿瘤;菌群失调;EN;乳酸杆菌 　　［摘　要］ 目的:对比研究胃肿瘤术后早期给予添加微生态制剂肠内营养的临床效果。方法：收集117例消化道肿瘤患者,并分别给予常规补液、肠外营养(PN)、肠内营养(EN)及添加微生态制剂肠内营养。监测患者手术前后内毒素、CRP、TNF水平变化及淋巴细胞计数改变，同时检测各组患者术后菌群失调情况并分类。结果:外周血内毒素水平术后EN组及添加微生态制剂EN患者均低于常规补液组和PN组（Plt;0.01），而添加微生态EN内毒素水平低于EN组（Plt;0.01）；术后EN组及添加微生态制剂EN患者CRP水平均低于常规补液组和PN组（Plt;0.01），而添加微生态肠内营养组CRP水平低于EN组（Plt;0.05）；外周血淋巴细胞计数添加微生态制剂EN术后较术前有所增加（Plt;0.05），其他三组无明显变化；各组患者术后TNF水平均高于术前水平，且术后添加微生态制剂肠内营养组TNF水平又明显高于其他各组（Plt;0.05）。各组患者术后第一次排便后细菌油镜计数结果肠内营养组及添加微生态制剂肠内营养组菌群失调患者例数明显少于常规补液组及EN组（Plt;0.01），而添加微生态制剂EN又低于肠内营养组（Plt;0.05）。结论：添加微生态制剂肠内营养能有效防治肠道菌群失调，预防术后感染，可加强胃肿瘤术后患者机体免疫。 　　［关键词］ 胃肿瘤;菌群失调;EN;乳酸杆菌 　　The Clinic Evaluation of Enteral Microecopharmaceutics Nutrition Instomach Neoplasm after Operation 　　Abstract:Objective To investigate and evaluate the clinical effect of enteral microecopharmaceutics nutrition early after operation in patient with stomach neoplasm.Methods 117 cases with Alimentary tract tumor were given normal liguid,parenteral nutrition(PN),enteral nutrition(EN) and enteral microecopharmaceutics nutrition(EMN).To analysis the changes of endotoxin,CRP,TNF and the number of lymphocyte in serum,and to detect the conditions of dysbacteriosis before and after operation.Results The level of endotoxin in serum markedly decreased in the normal and parenteral nutrition group compared with the enteral nutrition and enteral microecopharmaceutics nutrition group（Plt;0.01）,and in the enteral nutrition group,the endotoxin level was higher than the enteral microecopharmaceutics nutrition group（Plt;0.01）.After operation,the level of CRP in normal and PN group were significantly increased compared the EN and enteral microecopharmaceutics nutrition group（Plt;0.01）,and the EN group was higher than the enteral microecopharmaceutics nutrition group（Plt;0.05）.The number of lymphocyte in serum increased after operation in the enteral microecopharmaceutics nutrition group (Plt;0.05),the other three groups have not sign