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| Evaluation and application of nutritional and immune status in the perioperative period of colorectal cancer |
| GUO Fei1 ZHANG Xiaoyang2 LV Yanqin1 WU Xueliang1 SUN Guangyuan1 LI Minghui1 XUE Jun1▲ |
1.Department of General Surgery, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
2.Department of Physical Examination, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China |
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Abstract Objective To analyze the perioperative nutritional and immune status of colorectal cancer, and to provide evidence for clinical application. Methods From January 2014 to 2016 December, 100 cases of rectal cancer treated in the First Affiliated Hospital of Hebei North University were divided into intervention group and control group with random envelopes, with 50 cases in each group. The control group was treated with routine intervention, and the intervention group was intervened with nutritional support scheme. One d and 7 d before operation, 1, 4, 8 d and 15 d after operation. The levels of CD3+ T cells, CD4+ T cells, CD8+ T cells, IgG, IgA, IgM, ALB, PA, Hb and TF were counted, and the incidence of adverse reactions was statistically analyzed. Results Compared with 1 d before operation, the proportion of CD3+ and CD4+ T cells of the two groups was significantly decreased at 1 d after the operation, and the proportion of CD8+ T cells was significantly higher than that of 1 d before the operation, the differences were statistically significant (P < 0.05). The proportion of CD3+ and CD4+ T cells in the intervention group was significantly higher than those of the control group, and the CD8+ T cells was significantly lower than that of the control group, the differences were statistically significant (P < 0.05). One day after the operation, the levels of IgG, IgA and IgM of the two groups were lower than those 1 d before the operation, and the differences were statistically significant (P < 0.05), 4 d after the operation. The level of standard mean improvement of two groups was significantly higher than that of 1 d after operation (P < 0.05), and the level of IgG, IgA and IgM in the blood of the intervention group was significantly higher than that of the control group at 15 d after the operation, and the difference was statistically significant (P < 0.05). The levels of ALB, PA, TF and Hb of the two groups were significantly lower than those of 1 d before the operation, and the difference was significantly lower than the 1 d before the operation, the differences were statistically significant (P < 0.05). Four days after the operation, each index in the two groups were better than 1 d after the operation, the differences were statistically significant (P < 0.05), and the levels of ALB, PA, TF and Hb of the intervention group were significantly higher than those of the control group at 15 d after the operation, and the differences were statistically significant (P < 0.05). The total incidence of reaction was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). Conclusion Nutrition supplementation in the perioperative period of colorectal cancer patients can effectively improve the nutritional and immune status of the patients and reduce the incidence of adverse reactions in patients.
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[1] 郑树，张苏展，黄彦钦.结直肠癌研究30年回顾和现状[J].实用肿瘤杂志，2016，31（1）：2-5.
[2] 姚雨君，周航，刘霄.212例结直肠癌术后复发转移的危险因素分析[J].重庆医学，2016，45（2）：205-208.
[3] 刘建军，魏寿江.结肠癌术后肿瘤复发转移的影响因素及远期预后观察[J].中国现代普通外科进展，2017，20（1）：69-70.
[4] 刘启志，楼征，高显华，等.直肠癌患者术后生存与复发的临床病理因素探讨[J].中华普通外科杂志，2017，32（1）：5-8.
[5] 吕牮，关铁军，张冬霞，等.围手术期输血对胃癌患者术后感染的影响[J].中国实验诊断学，2016，20（8）：1313-1314.
[6] 王国年.麻醉与ERAS：肿瘤手术麻醉与远期预后[J].医学与哲学，2017，38（12）：22-25.
[7] 孙广荣，邹萍，董瑞强，等.围手术期营养支持对结直肠癌患者肿瘤细胞cyclin D1表达及复发转移的影响[J].实用癌症杂志，2017，32（8）：1328-1330.
[8] 詹天成，顾晋.NCCN 2016 V1版直肠癌诊治指南更新及其解读[J].实用肿瘤杂志，2016，31（4）：291-295.
[9] 赵晓敏，李云涛，季国忠.结直肠癌筛查现状与进展[J].中国临床研究，2016，29（6）：838-841.
[10] 王鲁，周嘉敏.结直肠癌肝转移术后复发的再手术治疗[J].肝胆外科杂志，2016，24（4）：241-243.
[11] 何纪恩，李晓花.结肠直肠恶性肿瘤手术部位感染原因分析[J].海南医学，2016，27（19）：3223-3224.
[12] 吕牮，关铁军，张冬霞，等.围手术期输血对胃癌患者术后感染的影响[J].中国实验诊断学，2016，20（8）：1313-1314.
[13] 施晓雷.肝癌肝移植术后肿瘤复发的围手术期防治措施[J].医学研究生学报，2017，30（8）：785-791.
[14] 郭添羽，黄昌浩，袁伟杰.术前营养风险筛查对胃癌和结肠癌患者围手术期营养支持的临床意义[J].中国现代医学杂志，2016，26（5）：119-123.
[15] 朱雪梅.饮食护理干预对胃癌根治术患者术后营养指标及免疫功能的影响[J].实用临床医药杂志，2016，20（18）：73-75.
[16] 高怀新.硬膜外复合全麻对结肠癌腔镜围术期患者的免疫抑制作用观察[J].结直肠肛门外科，2016（2）：130-133.
[17] 张素玲，刘婷婷，靳茜茜，等.影响恶性肿瘤手术患者围术期免疫功能的因素[J].医学综述，2017，23（11）：2176-2180.
[18] 张志发，王燕，陈堃，等.麻醉对免疫抑制与肿瘤复发的影响[J].生命的化学，2016（2）：213-218.
[19] 李道娟，梁迪，靳晶，等.河北省40年结直肠癌发病和死亡分析[J].中国癌症杂志，2017，27（3）：212-218.
[20] 李娜，席宏杰.麻醉对肿瘤患者免疫功能及术后复发的影响[J].实用药物与临床，2016，19（6）：786-789. |
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