百普素应用于结直肠癌围手术期病人临床观察.docVIP

百普素应用于结直肠癌围手术期病人临床观察 　【摘要】 目的 通过结直肠癌病人围手术期应用短肽制剂（百普素）,观察其辅助手术前肠道准备的效果、相关营养指标的变化以及对肠功能和术后免疫功能的影响。方法 将60例结直肠癌病人随机分为实验组（n=30）和对照组（n=30）。实验组于术前3天直至术后第7天给予肠内短肽制剂-百普素营养支持，对照组入院后给于采用传统的清洁灌肠方法，临床治疗和营养支持按常规处理（术前常规膳食，术后PN营养支持）。两组病人分别于术前1d、术后第1、3、7天分别检测白蛋白、球蛋白、免疫球蛋白（IgG、IgA、IgM）、T淋巴细胞亚群（CD3+、CD4+、CD4+/CD8+）水平，观察两组病人术中肠粘膜及肠道清洁情况、术后营养状况、免疫功能以及感染性并发症和住院时间的差异。结果 两组患者术中肠粘膜状况、肠道清洁度差异无统计学意义；术后两组病人各项营养指标、免疫指标水平均有不同程度下降，但实验组下降幅度低于对照组下降幅度（P＜0.01），实验组术后第7天免疫球蛋白IgG、IgA、IgM与对照组相比显著升高（P＜0.01）；术后感染性并发症的发生率低于对照组（P＜0.01）；实验组术后平均住院时间比对照组缩短（P＜0.01）。结论 结直肠癌围手术期应用短肽制剂百普素，更有利于病人营养状况和术后免疫功能的恢复以及预后改善，是结直肠癌病人围手术期的营养支持较佳的选择。 【关键词】 百普素 结直肠癌 营养支持 【Abstract】 Objective To observe the perioperative effect of peptisorb on intestinal preparation, correlated nutritional index, the function of intestine and the immune function after operation in colorectal cancer patients. Methods Sixty patients were randomly divided into two groups. The experimental group(n=30) received peptisorb 3 days before and 7 days after operation. Control group(n=30) received coloclysis treatment. The level of Alb, globulin, the number of IgG, IgA, IgM, the level of T lymphocyte, the station of intestinal mucosa and intestine cleaning during operation, nutritional state after operation, immune function, infectious complications the different of length of stay were detected.Results There were no significant difference in the station of intestinal mucosa and intestine cleaning. The index of nutritional and immune in two groups were reduced, but that of the experimental group is lower(P＜0.01). The number of IgG, IgA, IgM, CD3 in the experimental group were significantly higher than the control group(P＜0.01), the rate of postoperative infectious complications in the experimental group was lower than the control group. The trail group aslo showed shorter averang length of stay after surgery than the control（P＜0.01）.Conclusions The peptisorb can ameliorate the host immune function and improve clinical outcome, which is a good nutrition suppo