|
|
|
| The clinical significance of enteral nutritional emulsion combined with Polyethylene Glycol Electrolyte Powder in rectal cancer patientsˊ bowel preparation |
| DU Yuan1 YANG Benxin1 NIE Shuangfa2 LI Lei2 FEI Jiandong2▲ |
1.Graduate School, Hebei North University, Hebei Province, Zhangjiakou 075000, China;
2.Department of Gastrointestinal Surgery, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China |
|
|
|
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.
|
|
|
|
|
|
[1] 范朝刚，陈军.结直肠手术肠道准备作用评估[J].中国使用外科杂志，2016，36（2）：178-181.
[2] 胡艳杰，李卡，李立，等.术前机械性肠道准备对结肠癌患者早期康复疗效的印象：随机对照试验[J].南方医科大学学报，2017，37（1）：13-17.
[3] 陈剑辉，叶锦宁，宋武，等.肠内营养制剂在直肠癌根治术前肠道准备中的应用[J].中华胃肠外科杂志，2013，16（11）：1059-1062.
[4] 李骏强，赵子夜，于恩达.肠道准备质量评估量表应用现状[J].中华消化内镜杂志，2014，31（9）：539-542.
[5] 施章时，厉周，周五一，等.围手术期肠内营养治疗在结直肠癌中的临床应用研究[J]肠外与肠内营养，2014，21（4）：217-221.
[6] Navarro E，Escribano J，Fernández J，et al. Comparison of three different PCR methods for detection of Brucella spp in human blood samples [J]. FEMS Immunol Med Microbiol，2002，34（2）：147-151.
[7] 史亚丽，李彦平，张玉荣，等.复方聚乙二醇电解质散行结直肠癌肠道准备时C-反应蛋白的变化[J].护理学杂志，2013，18（16）：67.
[8] 刘彦，陶凯雄，王国斌，等.肠内营养用于术前肠道准备对结直肠癌患者腹腔和肠腔脱落癌细胞及复发转移的影响[J].中华胃肠外科杂志，2013，16（4）：350-353.
[9] 朱文强，吴震峰，曹勤洪，等.营养支持联合新辅助化疗在结直肠癌伴不全梗阻病人中的应用[J].肠外与肠内营养，2016，23（5）：290-292.
[10] 杨小云，丁进，陈燕萍，等.早期肠内营养支持对ICU脑卒中患者免疫功能及肠道黏膜屏障的影响[J].中国临床药理学与治疗学，2016，21（8）：935-938.
[11] 夏阳，杨喆，陈红旗，等.联合益生菌的快速肠道准备对结直肠癌术后肠道黏膜屏障功能的影响[J].中华胃肠外科杂志，2010，13（7）：528-531.
[12] 孟飞龙，王鑫，王登科，等.早期肠内营养对胃肠道手术后长黏膜屏障功能影响比较分析[J].中国实用外科杂志，2014，34（8）：779.
[13] 李东正，周建农，杨柳，等.维持肠内菌群稳定预防结直肠癌患者术后并发症的效果分析[J].肿瘤药学，2016，6（6）：428-432.
[14] 陈雪茹，贺德，谢从江，等.不同肠道准备方法对腹腔镜结直肠癌手术效果的影响[J].中国现代医生，2013，51（20）：84-85.
[15] 詹宏杰，梁寒.肠道菌群与结直肠癌关系研究进展[J].中国肿瘤临床，2015，53（13）：675-679.
[16] 李东正，周建农.肠道微生态制剂对结直肠癌患者术后免疫功能及并发症的影响[J].中国医药导报，2016，13（35）：106-109，114.
[17] 李卡，蒋理立，黄晓.结直肠癌术后早期肠内营养对胃肠功能恢复的影响[J].华西医学，2010，25（1）：216-217.
[18] 向德雨，郭朝阳，秦章禄，等.肠内营养乳剂与复方聚乙二醇电解质散在开腹结直肠癌患者术前肠道准备中的应用比较[J].中国基层医药，2015，22（9）：1413-1415
[19] 辛向红.聚乙二醇电解质散剂在结直肠癌术前肠道准备中的效果与安全性[J].中国老年学，2013，33（7）：1691-1692.
[20] 张杰.聚乙二醇电解质散剂在结肠镜术前肠道准备中的效果观察[J].实用临床医药杂志，2015，19（3）：143-144. |
|
|
|
