肠内免疫营养剂应用于围手术期胃癌病人的临床观察  

作　　者：周新华[1] 蒋晓松[1] 曾永红[1] 蔡德珺[1] 

机构地区：[1]广东省中医院珠海医院,519015

出　　处：《浙江临床医学》2010年第1期18-21,共4页Zhejiang Clinical Medical Journal

摘　　要：目的通过胃癌病人围手术期应用肠内免疫营养剂（瑞能），观察其对胃癌病人围手术期营养状况及术后免疫功能的影响。方法将80例胃癌病人随机分为实验组（n=40）和对照组（n=40），实验组于术前3d接受EN支持，给予肠内免疫营养制剂（瑞能）至术后7d；对照组术前常规膳食，术后给予TPN。两组病人分别于术前1d、术后第2天和第7天分别检测白蛋白（ALb）、前白蛋白（PA）、外周血淋巴细胞计数（TLC）、免疫球蛋白（IgG、IgA、IgM）、T淋巴细胞亚群（CD3^＋、CD4^＋、CD4^＋／CD8^＋）水平，观察两组病人相关营养指标、免疫指标及术后感染性并发症的差异。结果实验组较对照组术后胃肠功能恢复的更早，同时并发症的发生率明显低于对照组（P〈0．05），实验组前白蛋白等营养指标及免疫指标明显升高，与对照组相比差异有统计学意义（P〈0．05）。结论胃癌病人围手术期应用免疫营养剂EN，既能促进胃肠道功能尽早恢复，又可改善病人术后营养状况和免疫功能，有利于病人术后免疫功能的恢复和预后改善，是围手术期胃癌病人营养支持的较佳方案。Objective To observe the nutritional status and the effect of postoperative immune function of the patients with gastric cancer by using the enteral immune nutrition （RuiNeng） during the perioperative period. Methods Randomly separate 80 patients with gastric cancer into trial group （n = 40） and control group （n = 40）. The trial group had the EN support three days before the operation and was given the enteral immune nutrition （RuiNeng） until 7 days after the operation. The control group took the normal diet and was given TPN after operation. The levels of Alb, PA, TLC, IgG,IgA, IgM, CD3^＋, CD4^＋/CD8^＋ were tested of the two group on the day before the operation, 2^nd and 7^th day after operation to observe the differences of the nutritive index, immune index and the postoperative infectious complications. Results Comparing to the control group, the gastrointestinal function of the trial group recovered much earlier and the rate of the complications was significantly lower （ P 〈 0. 05 ）. The nutritive index such as PA, etc. and the immune index of the trial group were greatly elevated and had a remarkable difference with the control group（P 〈 0. 05）. Conclusions By using the EN immune nutrition during the perioperative period, the gastrointestinal function of the patients with gastric cancer can recover earlier and the nutritional status and the immune function can be improved as well. It helps to the recovery and the improvement of the postoperative immune function and has a good curative effect on the nutrition supports for the patients with gastric cancer during the perioperative period.

关 键 词：胃癌 肠内免疫营养 围手术期营养 

分 类 号：R735.34[医药卫生—肿瘤] R653[医药卫生—临床医学]