| Objective The study was using immune microecological nutritional support for enteral nutrition on hepatocellular carcinoma(HCC)patients during perioperative,then compared with the ordinary enteral nutrition and no enteral nutrition on the patients with same diseases,to observe whether immune microecological entera nutritional support can improve the nutritional status and the immune function of the patients during perioperative period,whether can reduce the incidence of postoperative complications.Methods 84 patients who were hospitalized in our general surgery department between January 2010 and March 2016 and diagnosed as hepatocellular carcinoma patients,who underwent hepatectomy and scored more than 3 points when evaluated with NRS-2002 nutritional risk screening score,were recruited in this study.They were randomly divided into three groups by random sampling method: control group(group A,26 cases,no enteral nutritional support),two experimental groups including group B(28 cases,ordinary enteral nutritional support,EN)and group C(30 cases,immune microecological enteral nutritional support,EIMN).Observed and compared the indexes of nutritional and immune among three groups of on admission(preoperative),Third day,Seventh day and Fourteenth day after operation,and compared the incidence of complications associated with nutritional support therapy(fever,abdominal distension,diarrhea,etc.).Results 1.Index of Nutrition and liver function: On admission(preoperative),There were no statistical significant differences among the three groups(P>0.05);Third day after operation,compared with preoperative status,the nutritional and liver function indexes became worse in all three groups(P<0.05).Group B and Group C became less worse than Group A,and transferrin level was higher than Group A(P<0.05).There were no statistical significant difference in the indexes between Group B and Group C(P>0.05).The body mass index(BMI)of three groups compared with preoperative,there was no statistical significance(P>0.05).Seventh4 day after operation,the indexes of nutrition and liver function had restored to preoperative level in group B and group C(P>0.05).Compared with the indexes of Third day after operation in Group A,Albumin and Prealbumin levels were slightly increased,and Transferrin,ALT,AST,GGT,total bilirubin were decreased,but still less than or higher than preoperative level(P<0.05).There were no statistical significant difference in the indexes between Group B and Group C(P>0.05).There were no difference between group B and group C in body mass index(BMI),but the body mass indexes(BMI)in the control group were significantly lower than that of Preoperative(P<0.05).Fourteenth day after operation,except body mass index(BMI),other indexes had restored to preoperative level in Group A(P>0.05).the liver function indexes in Group B and Group C had returned normal,but albumin,prealbumin,transferrin index were better than preoperative level(P<0.05).2.Index of Inflammation and Immune: On admission(preoperative): There were no statistically significant difference among the three groups(P>0.05).Third day after operation: Endotoxin inflammation factors in three group were obviously higher than preoperative levels,and immune indexes were lower than the preoperative levels(P < 0.05).Seventh day after operation: The indexes of inflammation and immune than the third day after operation were improved significantly(P < 0.05)in three groups;But EIMN group were better than the other two groups,the Indexes of EIMN group had basically recovered to preoperative levels(P > 0.05);The the Indexes of EN group were better than control group(P <0.05).Fourteenth day after operation: The inflammatory and immune EIMN group and EN group had recovered to preoperative levels,P > 0.05;The indexes of control group were improved significantly than Seventh day and Third day after operation,but still not recovered to preoperative levels(P < 0.05).Conclusion Malnutrition and immune dysfunction were happened on hepatocellular carcinoma patients.And state of stress response and immunosuppression were happened after resection of liver cancer patients.Rational enteral nutrition can decrease the immune dysfunction,and even can improved immune function.Especially Immune Microecological Enteral Nutrition,not onlycan obviously improve perioperative nutritional status,but also can obviously improve the patient's immune function,can significantly relieve inflammation and immune suppression after operation,and promote recovery. |
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