恶性梗阻性黄疸患者经皮经肝穿刺胆管引流术后不同营养支持与免疫功能的相关性分析

杨盛华; 张诚华; 杜凌红

doi:10.3969/j.issn.1001-5256.2014.11.014

恶性梗阻性黄疸患者经皮经肝穿刺胆管引流术后不同营养支持与免疫功能的相关性分析

DOI: 10.3969/j.issn.1001-5256.2014.11.014

中国人民解放军第一八医院普外科

基金项目:

南京军区重点课题资助项目(10MB018)；

详细信息

中图分类号: R657.4
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出版历程
- 收稿日期: 2014-08-11
- 出版日期: 2014-11-20

Relationship between ways of nutritional support and immune function in patients with malignant obstructive jaundice after PTCD

The 180th Hospital of Chinese PLA

Research funding:

摘要

摘要:
目的探讨不同营养方式对恶性梗阻性黄疸患者经皮经肝穿刺胆管引流术（PTCD）后免疫功能的影响。方法将中国人民解放军第一八○医院2009年1月-2013年3月收治的50例恶性梗阻性黄疸患者根据入院先后顺序随机分为2组,每组各25例。A组患者PTCD术后接受肠内营养支持,B组患者PTCD术后接受全静脉营养支持,分别于术前1 d、术后7 d比较两组患者的退黄效果、营养状况以及机体免疫功能的变化。两组间比较采用t检验。结果 50例接受PTCD术患者中39例引流效果理想,占78%,11例患者引流效果欠佳,占22%,其中A组5例（10%）,B组6例（12%）。两种营养支持方法治疗后其营养指标明显高于治疗前,差异均有统计学意义（P<0.05）,但a组与b组治疗后各指标差异无统计学意义（p>0.05）。通过PTCD以及营养支持治疗后两组患者的免疫功能均得到提升,与治疗前比较差异均有统计学意义（P<0.05）,但a组与b组之间的免疫功能差异无统计学意义（p>0.05）;11例患者经过PTCD术后退黄效果不明显,这部分患者的虽然也接受相同方案的营养支持治疗,其免疫能力的提升幅度较术后...
- 黄疸,阻塞性 /
- 经皮经肝穿刺胆管引流 /
- 肠道营养 /
- 胃肠外营养,全
Abstract:
Objective To investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD) . Methods A total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admission order. The patients in group A (n = 25) received enteral nutritional support after PTCD, and those in group B (n = 25) received total parenteral nutritional support after PTCD. Intra- group and inter- group comparisons were made in terms of jaundice clearance, nutritional indices, and body's immune function on preoperative day 1 and postoperative day 7; comparison between the two groups was made by t test.Results Among the 50 patients who underwent PTCD, 39 (78%) had good drainage, while 11 (22%) did not reach the expectation, of which, 5 (10%) were in group A and 6 (12%) in group B. In both groups, the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1 (P < 0. 05) , but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P > 0. 05) . The immune function of patients in both groups was significantly improved following PTCD and nutritional support (P < 0. 05) , but there was no significant difference between the two groups (P > 0. 05) . Although the same scheme of nutritional support was used, there were 11 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P < 0. 05) . Conclusion Jaundice clearance is closely related to PTCD in patients with malignant obstructive jaundice, but not markedly associated with the ways of nutritional support.
- jaundice, obstructive /
- percutaneous transhepatic cholangial drainage /
- enteral nutrition /
- parenteral nutrition, total

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参考文献(11)

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