肠内营养乳剂联合复方聚乙二醇电解质散在直肠癌患者术前肠道准备中的临床应用意义(1)
[摘要] 目的 探討肠内营养乳剂联合复方聚乙二醇电解质散在直肠癌患者术前肠道准备中的临床应用意义。 方法 选择2015年12月～2017年5月河北北方学院附属第一医院普外科收治的61例接受手术治疗的直肠癌患者作为研究对象，采用随机数字表法分为观察组31例和对照组30例。观察组术前给予口服复方聚乙二醇电解质散和肠内营养，对照组给予传统方法进行肠道准备，比较两组患者肠道准备效果及肠黏膜细胞跨膜结合蛋白(occludin蛋白)和IhA表达水平。 结果 两组患者术后肠道清洁程度比较，差异无统计学意义(P > 0.05)，观察组患者对肠道准备的耐受性优于对照组(P < 0.05)。两组患者术前均出现双歧杆菌/大肠埃希菌(B/E)比值倒置，术后观察组的B/E比值显著增加，对照组B/E倒置则相比术前更为显著(P < 0.05)。术后第7天观察组血中细菌DNA明显低于对照组(P < 0.05)，观察组手术标本中occludin蛋白阳性细胞百分比及IgA阳性百分比均明显高于对照组(P < 0.05)；术后观察组患者静脉血中C反应蛋白含量、平均心率均显著低于对照组，其术后发热持续时间和白细胞计数恢复正常时间均明显短于对照组(P < 0.05)，而两组患者术后并发症发生率比较，差异无统计学意义(P > 0.05)。 结论 术前口服复方聚乙二醇电解质散联合肠内营养乳剂，能改善直肠癌患者耐受情况，降低肠道免疫屏障的损伤程度，并且能减少术后早期全身炎性反应和局部并发症的发生，从而促进患者术后恢复。
[关键词] 直肠癌；肠道准备；肠内营养；复方聚乙二醇电解质散
[中图分类号] R735.34 [文献标识码] A [文章编号] 1673-7210(2017)12(c)-0104-05
[Abstract] Objective To investigate the clinical significance of enteral nutritional emulsion combined with Polyethylene Glycol Electrolyte Powder in rectal cancer patients′ bowel preparation. Methods From December 2015 to May 2017， 61 patients with rectal cancer treated with surgery in Department of General Surgery， the First Affiliated Hospital of Hebei North University were selected as research objects， and they were divided into observation group (31 cases) and control group (30 cases) by random number table. The observation group was given to oral Compound Polyethylene glycol Electrolyte Powder and enteral nutrition before operation， and the control group was given to intestinal preparation of traditional mechanical enema. The effects of bowel preparation and the expression of intestinal epithelial tight junction protein (occludin) and IgA in intestinal mucosa between two group were compared. Results There was no significant difference in intestinal cleanliness between the two groups (P > 0.05). The tolerance of bowel preparation of patients in observation group was better than control group (P < 0.05). Preoperative Bifidobacterium / E.coli (B/E) ratio was reversed in the two groups. The B/E ratio in the observation group was increased significantly after the surgery， while the postoperation B/E reversal ratio was decreased significantly in the control group (P < 0.05). Seven days after surgery， the bacterial DNA in blood in the observation group was significantly lower than those in control group (P < 0.05)， the percentage of positive in occludin protein cells and IgA in the observation group was significantly lower than those in the control group (P < 0.05). The intravenous blood C reactive protein content and average heart rate in the observation group were significantly lower than those in control group， and the duration of fever and the time of white blood cell count to normal were significantly shorter than those in the control group (P < 0.05). While the incidence of postoperative complications of the two groups was not statistically significant (P > 0.05). Conclusion Oral Compound Polyethylene Glycol Electrolyte Powder and enteral nutrition before surgery， which can improve tolerance of the patients with rectal cancer， reduce injury degree of intestinal immunological barrier， decrease the occurrence of systemic inflammatory reaction and local complications during early period of postoperation， in order to promote postoperative recovery., 百拇医药(杜园 杨本鑫 聂双发)
[关键词] 直肠癌；肠道准备；肠内营养；复方聚乙二醇电解质散
[中图分类号] R735.34 [文献标识码] A [文章编号] 1673-7210(2017)12(c)-0104-05
[Abstract] Objective To investigate the clinical significance of enteral nutritional emulsion combined with Polyethylene Glycol Electrolyte Powder in rectal cancer patients′ bowel preparation. Methods From December 2015 to May 2017， 61 patients with rectal cancer treated with surgery in Department of General Surgery， the First Affiliated Hospital of Hebei North University were selected as research objects， and they were divided into observation group (31 cases) and control group (30 cases) by random number table. The observation group was given to oral Compound Polyethylene glycol Electrolyte Powder and enteral nutrition before operation， and the control group was given to intestinal preparation of traditional mechanical enema. The effects of bowel preparation and the expression of intestinal epithelial tight junction protein (occludin) and IgA in intestinal mucosa between two group were compared. Results There was no significant difference in intestinal cleanliness between the two groups (P > 0.05). The tolerance of bowel preparation of patients in observation group was better than control group (P < 0.05). Preoperative Bifidobacterium / E.coli (B/E) ratio was reversed in the two groups. The B/E ratio in the observation group was increased significantly after the surgery， while the postoperation B/E reversal ratio was decreased significantly in the control group (P < 0.05). Seven days after surgery， the bacterial DNA in blood in the observation group was significantly lower than those in control group (P < 0.05)， the percentage of positive in occludin protein cells and IgA in the observation group was significantly lower than those in the control group (P < 0.05). The intravenous blood C reactive protein content and average heart rate in the observation group were significantly lower than those in control group， and the duration of fever and the time of white blood cell count to normal were significantly shorter than those in the control group (P < 0.05). While the incidence of postoperative complications of the two groups was not statistically significant (P > 0.05). Conclusion Oral Compound Polyethylene Glycol Electrolyte Powder and enteral nutrition before surgery， which can improve tolerance of the patients with rectal cancer， reduce injury degree of intestinal immunological barrier， decrease the occurrence of systemic inflammatory reaction and local complications during early period of postoperation， in order to promote postoperative recovery., 百拇医药(杜园 杨本鑫 聂双发)