首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2014年 11期 => 胆汁淤积和胆道疾病 =>恶性梗阻性黄疸患者经皮经肝穿刺胆..
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
Relationship between ways of nutritional support and immune function in patients with malignant obstructive jaundice after PTCD
文章发布日期:2014年10月17日  来源:  作者:杨盛华,张诚华,杜凌红  点击次数:1337次  下载次数:294次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【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退黄效果好的患者小(P均<0.05)。结论恶性梗阻性黄疸患者退黄效果与PTCD术密切相关,与何种途径的营养方式关系不明显。
【Abstract】:ObjectiveTo investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD). MethodsA 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. ResultsAmong 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). ConclusionJaundice clearance is closely related to PTCD in patients with malignant obstructive jaundice, but not markedly associated with the ways of nutritional support.
【关键字】: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
【Key words】:jaundice, obstructive; percutaneous transhepatic cholangial drainage; enteral nutrition; parenteral nutrition, total
【引证本文】:

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号