|本期目录/Table of Contents|

[1]万 音,程 曼,王梦影,等.膳食纤维肠内营养制剂对结直肠癌患者术后肠道屏障应激及营养指标的影响[J].天津医科大学学报,2019,25(02):105-109.
 WAN Yin,CHENG Man,WANG Meng-ying,et al.Effect of dietary fiber enteral nutrition preparation on postoperative intestinal barrier stress and nutritional index in patients with colorectal cancer[J].Journal of Tianjin Medical University,2019,25(02):105-109.
点击复制

膳食纤维肠内营养制剂对结直肠癌患者术后肠道屏障应激及营养指标的影响(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25
期数:
2019年02期
页码:
105-109
栏目:
基础医学
出版日期:
2019-03-20

文章信息/Info

Title:
Effect of dietary fiber enteral nutrition preparation on postoperative intestinal barrier stress and nutritional index in patients with colorectal cancer
文章编号:
1006-8147(2019)02-0105-05
作者:
万 音程 曼王梦影杨 柳张绪梅
(天津医科大学公共卫生学院营养与食品卫生教研室,天津300070)
Author(s):
WAN Yin CHENG Man WANG Meng-ying YANG Liu ZHANG Xu-mei
(Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China)
关键词:
结直肠癌膳食纤维降钙素原D-乳酸
Keywords:
colorectal cancerdietary fiberprocalcitoninD - lactic acid
分类号:
R151.1
DOI:
-
文献标志码:
A
摘要:
目的:观察膳食纤维肠内营养制剂对CRC患者术后肠道屏障功能、炎症应激反应以及肠道动力功能恢复的影响,并对术后患者的营养状态进行评价。方法:选取65名结直肠癌患者,术后随机分为含膳食纤维组(DF组)与非膳食纤维组(NDF组)。对两组患者肠道屏障功能指标血D-乳酸与DAO值;炎性因子指标WBC、CRP、IL-6、TNF-α和PTC水平;营养指标ALB、PA、TRF水平以及术后不良反应及并发症进行比较分析。结果:两组患者术后DAO水平与术前比较均显著下降,术后NDF组D-乳酸水平均与术前相比无统计学差异,但有降低趋势;术后DF组D-乳酸与DAO水平均低于NDF组,差异有统计学意义(P<0.05)。除NDF组WBC和CRP外,患者术后炎症因子水平与术前比较均降低;与NDF组相比,DF组术后炎症因子WBC、CRP、IL-6、TNF-α和PTC水平显著降低,差异有统计学意义(P<0.05)。除NDF组TRF因子外,患者术后营养指标水平与术前比较均显著升高;术后DF组与NDF组营养指标水平比较无统计学差异,但有升高的趋势。术后排气、便时间比较, DF组显著低于NDF组,有统计学差异(P<0.05),创口感染、恶心呕吐和死亡指标比较无统计学差异(P>0.05)。结论:结直肠癌患者术后早期给予含膳食纤维肠内营养制剂治疗,能显著改善患者肠道屏障功能、恢复胃肠动力,抑制肠道内炎症应激反应,改善患者术后状况。
Abstract:
Objective: To observe the effect of dietary fiber enteral nutrition on postoperative intestinal barrier function, inflammatory stress response and intestinal dynamic recovery of CRC patients, and to evaluate the nutritional status of postoperative patients. Methods: Sixty-five patients with colorectal cancer were randomly divided into 2 groups: dietary fiber (DF group) and non-dietary fiber (NDF group). Blood D-lactic acid and DAO values of intestinal barrier function indexes in two groups of patients; Inflammatory factor index the WBC, CRP, IL-6, TNF-α and PTC level;ALB, PA, TRF levels, postoperative adverse reactions and complications were compared and analyzed. Results: The postoperative DAO level of patients in both groups decreased significantly compared with that before surgery, and the postoperative D-lactic acid level of patients in the NDF group showed no statistical difference compared with that postsurgical results, but there was a decreasing trend. The levels of D-lactic acid and DAO in postoperative DF group were lower than those in NDF group, and the difference was statistically significant (P<0.05). In addition to WBC and CRP in the NDF group, the postoperative inflammatory factors were decreased compared with those before surgery. Compared with the NDF group, postoperative inflammatory factor the WBC DF group, CRP, IL-6, TNF-α and PTC were significantly reduced, and the difference was statistically significant (P<0.05). In addition to the TRF factor in the NDF group, the postoperative nutrition index level of the patients increased significantly compared with the preoperative level. Postoperative DF group and NDF group showed no significant difference in nutritional indicators, but there was an upward trend. Compared with postoperative exhaustion and defecation time, the DF group was significantly lower than the NDF group (P<0.05), and there was no statistically significant difference in wound infection, nausea, vomiting and mortality (P>0.05). Conclusion: early postoperative enteral nutrition preparations containing dietary fiber can significantly improve the intestinal barrier function and restore gastrointestinal dynamics. It could also inhibit intestinal inflammatory stress reaction and improve postsurgical conditions.

参考文献/References:


[1] Siegel R L, Miller K D. Ahmedinjemal DVM PhD.cancer statistics,2015[J].CA Cancer J Clin,2015,65(1):5
[2] Saetang J, Sangkhathat S. Diets Link metabolic syndrome and colorectal cancer development(Review)[J].Oncol Rep,2017,37(3):1312
[3] Lewis S J, Andersen H K, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta-analysis[J].J Gastrointest Surg,2009, 13(3):569
[4] Kau A L, Ahern P P, Griffin N W, et al. Human nutrition, the gut microbiome and the immune system[J].Nature,2011,474(7351):327
[5] Zavertaǐlo L L, Semen’kova G V, Leǐderman I N. Effect of an original enteral feeding protocol on clinical outcome indicators in patients with acute cerebral damage of vascular and traumatic genesis[J]. Anesteziol Reanimatol, 2010(4):35
[6] Louis P, Flint H J. Diversity, metabolism and microbial ecology of butyrate-producing bacteria from the human large intestine[J].FEMS Microbiol Lett,2009,294(1):1
[7] Tailor D, Hahm E R, Kale R K, et al. Sodium butyrate induces DRP1-mediated mitochondrial fusion and apoptosis in human colorectal cancer cells[J].Mitochondrion,2014,16(SI):55
[8] Song M Y, Wu K A, Meyerhardt J A, et al. Fiber intake and survival after colorectal cancer diagnosis[J]. JAMA Oncol, 2018,4(1):71
[9] 中华医学会重症医学分会.危重病人营养支持指导意见(2006)[J].中国实用外科杂志,2006,26(10):721
[10] 翟凤英,何宇纳,胡以松,等.中国居民2002年膳食纤维的摄入现状[J].营养学报,2005,27(6):444
[11] Siegel R L, Miller K D, Fedewa S A, et al. Colorectal cancer statistics, 2017[J].CA Cancer J Clin,2017,67(3):104
[12] Kolligs F T. Diagnostics and epidemiology of colorectal cancer[J].Visc Med, 2016,32(3):158
[13] Brenner H, Hakulinen T. Up-to-date estimates of cancer patient survival even with common latency in cancer registration[J].Cancer Epidemiol Biomarkers Prev, 2006,15(9):1727
[14] 甄潮辉,李富荣,余小舫.粪便微 RNA 检测用于结直肠癌早期筛查的研究[J].中华消化杂志,2015,35(8):574
[15] 张骞, 陈庆民,王锡山.预防性回肠造口在低位直肠癌中的应用[J].中华胃肠外科杂志,2016,19(4):469
[16] 潘勇.大肠癌右半结肠切除患者肠道菌群变化及意义[J].山东医药,2017,57(12):48
[17] 钟磊,陈叶恒,董宁,等.结直肠癌患者术后不同营养支持途径的对比分析[J].重庆医学,2014,43(35):4808
[18] Ward N. Nutrition support to patients undergoing gastrointestinalsurgery[J].Nutr J, 2003,2(1):18
[19] Van Barneveld K W, Smeets B J, Heesakkers F F, et al. Beneficial effects of early enteral nutrition after major rectal surgery:a possible role for conditionally essential amino acidsresults of a randomized clinical trial[J].Crit Care Med,2016,44(6):e353
[20] 周红飞,张文熠,陆少波,等.早期肠内营养支持对腹腔镜结直肠癌患者术后营养、应激及预后的随机对照研究[J].中华普通外科学文献:电子版,2017,11(4):222
[21] Gianfredi V, Salvatori T, Villarini M, et al. Is dietary fibre truly protective against colon cancer? A systematic review and meta-analysis[J]. Int J Food Sci Nutri, 2018,69(8):904
[22] Li H X, Chen Y, Huo F F, et al. Association between acute gastrointestinal injury and biomarkers of intestinal barrier function in critically ill patients[J].BMC Gastroenterol, 2017,17(1):45
[23] Karabulut K U, Narci H, Gul M, et al. Diamine oxidase in diagnosis of acute mesenteric Ischemia[J].Am J Emerg Med,2013,31(2):309
[24] Sarbinowski R, Arvidsson S, Tylman M, et al. Plasma concentration of procalcitonin and systemic inflammatory response syndrome after colorectal surgery[J]. Acta Anaesthesiol Scand,2005,49(2):191
[25] Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J].Lancet,1993, 341(8844):515
[26] 熊明洁,范红,郭靓.80例脓毒血症患者血清降钙素原监测和预后评估的临床研究[J].重庆医学,2011,40(30):3076
[27] Chen J, Vitetta L. Inflammation-modulating effect of butyrate in the prevention of colon cancer by dietary fiber[J]. Clin Colorectal Cancer, 2018, 17(3):e541
[28] Liu J, Xia Q. Relationship of dietary fiber and early enteral nutrition with digestive complications after surgical treatment of gastric cancer[J]. Zhong hua Wei Chang Wai Ke Za zhi, 2005, 8(3):223
[29] Xu R, Ding Z, Zhao P, et al.The effects of early Post-Operative soluble dietary fiber enteral nutrition for colon cancer[J].Nutrients,2016,8(9):584

相似文献/References:

[1]付 蔷,徐文贵,于筱舟,等.早期18F-FDG PET/CT显像在结直肠癌术后再分期中的临床价值[J].天津医科大学学报,2017,23(01):38.
 FU Qiang,XU Wen-gui,YU Xiao-zhou,et al.Value of early postoperative 18F-FDG PET/CT in restaging of the colorectal carcinoma[J].Journal of Tianjin Medical University,2017,23(02):38.
[2]吕文浩,王 吉,魏 颖,等.腹腔内脂肪面积和体质量指数对腹腔镜结直肠癌根治术及术后短期结局的影响[J].天津医科大学学报,2018,24(05):420.
 lv Wen-hao,WANG Ji,WEI Ying,et al.Impacts of intra-abdominal fat area and body mass index on laparoscopic surgery for colorectal cancer and short surgical outcomes[J].Journal of Tianjin Medical University,2018,24(02):420.
[3]贾朝阳,徐文贵,朱 磊,等.18F-FDG PET/CT在结直肠癌术后预后中的应用[J].天津医科大学学报,2019,25(04):342.
 JIA Zhao-yang,XU Wen-gui,ZHU Lei,et al.The application of 18F-FDG PET/CT in the prognosis of postoperative colorectal cancer[J].Journal of Tianjin Medical University,2019,25(02):342.

备注/Memo

备注/Memo:
基金项目 唐山市科技计划项目资助(13130275b) 作者简介 万音(1986-),女,硕士在读,研究方向:消化系统肿瘤;通信作者:张绪梅,E-mail: zhangxumei@tmu.edu.cn。
更新日期/Last Update: 2019-04-25