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免疫营养对结直肠癌手术患者营养状况的影响:一项随机对照临床试验。

Impact of Immunonutrition on Nutritional Status in Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Clinical Trial.

机构信息

Department of Nutrition and Dietetics, University of Health Sciences, Istanbul, Turkey.

Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

Nutr Cancer. 2024;76(6):469-475. doi: 10.1080/01635581.2024.2338607. Epub 2024 Apr 13.

Abstract

This study aimed to investigate the additional effects of perioperative immunonutrition (IMN) compared with preoperative immunonutrition (IMN) on anthropometric, nutritional, and biochemical parameters, hospital stay and postoperative complications in patients with colorectal cancer. Oral supplementation enriched with arginine, omega-3 fatty acids, and dietary nucleotides was given to 25 patients before and after the operation (Group 2); 25 patients received the same formula before surgery and standard isocaloric nutrition following the operation (Group 1). Postoperative body weight, body mass index (BMI), and middle upper arm circumference (MUAC) of Group 1 decreased more than Group 2 during follow-up ( < 0.05). The biochemical parameters, C-reactive protein (CRP), aspartate aminotransferase (AST) and fasting plasma glucose (FPG) were higher, and albumin was lower than the baseline in Group 1 compared to Group 2 ( < 0.05). There was a negative correlation between CRP and Nutrition Risk Screening (NRS) 2002 scores, and prealbumin and NRS 2002 scores had a positive correlation ( = 0.007,  = 0.384;  = 0.012,  = 0.352). There was no difference in hospital stay and postoperative complications between the groups ( > 0.05). Perioperative immunonutrition, compared to preoperative immunonutrition, can be used as a positive and effective approach in improving some anthropometric measurements and biochemical parameters in patients undergoing colorectal cancer surgery.

摘要

本研究旨在探讨与术前免疫营养(IMN)相比,围手术期免疫营养(IMN)对结直肠癌患者的人体测量学、营养和生化参数、住院时间和术后并发症的附加影响。术前和术后给予 25 例患者富含精氨酸、ω-3 脂肪酸和膳食核苷酸的口服补充剂(第 2 组);25 例患者在手术前接受相同的配方,并在手术后接受标准等热量营养(第 1 组)。在随访期间,第 1 组的术后体重、体重指数(BMI)和中上臂围(MUAC)比第 2 组下降更多(<0.05)。与第 2 组相比,第 1 组的生化参数 C 反应蛋白(CRP)、天冬氨酸转氨酶(AST)和空腹血糖(FPG)更高,白蛋白更低(<0.05)。CRP 与营养风险筛查(NRS)2002 评分呈负相关,而前白蛋白与 NRS 2002 评分呈正相关(=0.007,=0.384;=0.012,=0.352)。两组间住院时间和术后并发症无差异(>0.05)。与术前免疫营养相比,围手术期免疫营养可作为改善结直肠癌手术患者某些人体测量学和生化参数的积极有效方法。

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