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目的 :研究老年大肠癌病人行根治术后进行全肠外营养支持 ,对术后恢复、胃肠道功能恢复、创口愈合及免疫功能的影响。 方法 :对 42例 6 5岁以上的大肠癌病人随机分为实验组 (TPN组 )和对照组 (非 TPN组 )。实验组采用全营养混合液 (TNA)经颈内静脉输注 ,从术后第 1天起每天输注 ,连续 8～ 9天 ,每天提供非蛋白热量 83.7～12 5 .5 k J(2 0～ 30 kcal) /(kg· d) ,氮 0 .12～ 0 .16 g/(kg· d) ,脂肪占总热量约 2 0 %～ 30 % ;对照组术后常规给予葡萄糖与电解质溶液 ,逐步过渡到口服饮食。观察术后胃肠功能的恢复和创口愈合情况 ,检测术前第 1天、术后第 1天及第 8天血清白蛋白、前白蛋白、免疫球蛋白 (Ig G、Ig A、Ig M)及 T细胞亚群的变化。 结果 :实验组胃肠功能恢复时间和创口愈合情况均优于对照组 ,前白蛋白、Ig G与 Ig A水平、CD3+与 CD4+细胞百分率均较对照组显著升高(P<0 .0 1)。 结论 :全肠外营养对术后老年大肠癌病人具有提高机体营养状况、促进胃肠道功能尽早恢复以及创口更好愈合 ,同时能明显改善术后应激期机体免疫功能
Objective : To study the effects of total parental nutrition support after radical resection of elderly patients with colorectal cancer on postoperative recovery, gastrointestinal function recovery, wound healing and immune function. Methods: Forty-two patients with colorectal cancer over the age of 65 years were randomly divided into experimental group (TPN group) and control group (non-TPN group). The experimental group was treated with TNA via internal jugular vein infusion. Daily infusions were performed from day 1 postoperatively for 8 to 9 days, providing non-protein calories of 83.7 to 125.5 kJ per day (20 ~ 30 kcal) / (kg · d), nitrogen 0.112 ~ 0.16 g / (kg · d), fat accounts for 20% ~ 30% of the total calories; the control group after the routine administration of glucose and electrolyte solution, Gradually transition to oral diet. Observe the recovery of gastrointestinal function and wound healing. Detect serum albumin, prealbumin, and immunoglobulin (Ig G, Ig A, Ig M) on the first day before operation, the first day and the eighth day after operation. And changes in T cell subsets. Results: The recovery time of gastrointestinal function and wound healing in the experimental group were better than those in the control group. The levels of prealbumin, Ig G and Ig A, and CD3+ and CD4+ cells were significantly higher than those in the control group (P < 0.01). . Conclusion: Total parenteral nutrition can improve the body’s nutritional status, promote the early recovery of gastrointestinal function and better healing of wounds in patients with postoperative elderly patients with colorectal cancer. At the same time, it can significantly improve the immune function in postoperative stress period.