目的:探讨术前10天进行口服营养补充对口腔癌患者术前营养状况、免疫功能和术后感染性并发症的影响。方法:经营养风险筛查2002(NRS-2002)评分筛查的40例存在营养风险的老年口腔癌术前患者按随机数表法分为观察组和对照组,各20例。两组术后均按照能量、蛋白质的目标需求量进行动态营养支持,对照组术前给予常规营养宣教,观察组在对照组的基础上给予能全素联合乳清蛋白粉口服营养补充,比较两组干预前后的营养状态指标、免疫功能指标、术后感染性并发症的变化。结果:干预后观察组白蛋白、前白蛋白均明显高于对照组,差异均有统计学意义(P＜0.05);RBC、HB和对照组比较,差异无统计学意义(P＞0.05)。干预后观察组IgA、CD4、CD4/CD8明显高于对照组,观察组C反应蛋白明显低于对照组,差异均有统计学意义(P＜0.05);干预后观察组IgG、IgM、CD3、CD8、NK细胞与对照组比较,差异无统计学意义(P＞0. 05)。干预后观察组并发症总例数所占比例明显低于对照组,差异有统计学意义(P＜0.05)。结论:能全素联合乳清蛋白粉术前口服营养补充有助于改善口腔癌患者术前营养状况、免疫功能,降低术后感染性并发症的发生。

Objective: To investigate the effects of oral nutrition supplementation 10 days before surgery on preoperative nutritional status, immune function and postoperative infectious complications in patients with oral cancer. Methods: A total of 40 elderly patients with preoperative oral cancer who were screened by Nutritional Risk Screening 2002 (NRS-2002) score were divided into observation group and control group according to random number table method, with 20 patients in each group. The two groups were given dynamic nutritional support according to the target demand of energy and protein after operation. The control group was given routine nutritional education before operation. The observation group was given Nengquansu combined with whey protein powder oral nutrition supplement on the basis of the control group. The changes of nutritional status indexes, immune function indexes and postoperative infectious complications before and after intervention were compared between the two groups. Results: After intervention, the levels of albumin and prealbumin in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P＜0.05), while there was no significant difference in RBC, HB between the observation group and the control group (P＞0.05). After intervention, IgA, CD4 and CD4/CD8 of the observation group were significantly higher than those of the control group, while C-reactive protein of the observation group was significantly lower than that of the control group, the differences were statistically significant (P＜0.05). After intervention, there was no significant difference in IgG, IgM, CD3, CD8 and NK cells between the observation group and the control group (P＞0.05). After intervention, the proportion of the total number of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P＜0.05). Conclusion: The preoperative oral nutritional supplement of Nengquansu combined with whey protein powder can improve the preoperative nutritional status and immune function of patients with oral cancer, and reduce the incidence of postoperative infectious complications.