早期肠内营养对胃癌患者根治术后临床结局的影响  

Influence of Early Enteral Nutrition on Postoperative Clinical Effects of Gastric Cancer Patients Treated with Radical Operations

作　　者：李卫[1] 周铃[1] 孙浩[1] 陈刚[1] 陈利辉[1] 

机构地区：[1]重庆市肿瘤研究所,400030

出　　处：《实用癌症杂志》2014年第1期56-61,61,共4页The Practical Journal of Cancer

摘　　要：目的探讨早期肠内营养对胃癌根治术患者术后临床结局的影响。方法将需经胃癌根治术治疗的胃癌患者100例随机分为观察组与对照组,每组50例。对照组患术后采取肠外营养治疗,观察组患者术后采取早期肠内营养治疗。观察并比较2组患者治疗后的临床结局,并对2组患者术后免疫功能及营养状况进行评价。结果观察组患者术后发热时间、肠功能恢复时间、排气时间、住院时间均明显短于对照组;2组患者术后第1天的CD3+、CD4+、CD4+/CD8+、NK各免疫细胞活性较术前均明显降低(P<0.05),而CD8+无明显降低,且组间比较无明显差异(P>0.05);经营养治疗后,观察组患者术后第7天的CD3+、CD4+、CD4+/CD8+、NK各免疫细胞活性分别为(35.6±4.2)%、(42.2±3.0)%、(1.7±0.3)%、(27.3±5.3)%,接近于术前水平,而对照组仍明显低于术前,且低于肠内营养组,P<0.05,具统计学意义。结论胃癌根治术患者早期肠内营养治疗后的临床结局较好,患者术后免疫功能及营养状况均明显改善,值得在临床上广泛应用。Objective To investigate the influence of early enteral nutrition on gastric cancer patients after radical gas -trectomy .Methods 100 cases of gastric cancer patients were randomly divided into the observation group and the control group , 50 cases in each group .The control group received parenteral nutrition therapy ,the observation group were treated with early en-teral nutrition therapy .The clinical outcomes of the 2 groups were observed and compared after treatment ,,and postoperative im-mune function and nutritional status were evaluated .Results The time of postoperative fever , intestinal function recovery , ex-haust,and hospitalization of the observation group were significantly shorter than those of the control group ;CD3+,CD4+,CD4+/CD8+,NK and various immune cells activity of the 2 groups first day after surgery were significantly lower than before the surgery (P<0.05),and CD8+had no significant decrease,there was no significant difference (P>0.05);the CD3+,CD4+, CD4+/CD8+,NK activity of various immune cells in the observation group after the first 7 days were (35.6 ±4.2)%,(42.2 ± 3.0)%,(1.72 ±0.27)%,(27.3 ±5.3)%,respectively,close to the preoperative levels,while the control group was still signif-icantly lower than before the surgery ,and less than enteral nutrition group ,P<0.05,it was statistically significant .Conclusion Early enteral nutrition in patients treated with radical gastrectomy has better clinical outcome ,immune function and nutritional sta-tus of patients are significantly improved ,it is worth of clinical application .

关 键 词：早期肠内营养( EEN) 胃癌根治术 临床结局 免疫功能 营养状态 

分 类 号：R735.2[医药卫生—肿瘤]