围手术期应用肠内免疫营养对胃癌术后患者免疫功能和营养状况的药理作用  

Nutritional Function of Enteral Immunonutrition for the Improvement of Immune Function and Nnutritional Status in Gastric Cancer Patients during and ater Surgery

作　　者：宁志超[1] 

机构地区：[1]成都市新都区第二人民医院外科,成都610501

出　　处：《华西医学》2013年第11期1662-1664,共3页West China Medical Journal

基　　金：教育部博士点基金资助课题(20070610146)~~

摘　　要：目的探讨围手术期强化免疫营养素肠内营养支持对胃癌患者免疫功能和营养状况的影响。方法将2007年3月-2012年12月间24例胃癌术后患者随机分为肠内免疫营养组(研究组)和常规肠内营养组(对照组),每组12例,进行等氮等热量营养支持,术前5 d至术后7 d。测定营养支持前后的血清白蛋白、前白蛋白、转铁蛋白、T淋巴细胞亚群及血清免疫球蛋白等指标变化。临床观察胃肠功能恢复时间。结果术后两组患者血清蛋白水平和免疫指标多有下降,但研究组术后8 d的血清前白蛋白水平和IgG、CD4/CD8比值较对照组明显增加,研究组胃肠功能恢复时间早于对照组。结论围手术期应用强化免疫肠内营养支持可改善胃癌患者术后营养和免疫状况,促进肠道功能恢复。Objective To evaluate the clinical effect and safety of perioperative enteral immunonutrition for the improvement of immune function and nutritional status in gastric cancer patients. Methods Twenty-four patients with gastric cancers treated in our hospital between March 2007 and December 2012 were randomly divided into two groups： the enteral immunonutrition group （study group） and conventional enteral nutrition group （control group）. All the patients were given isocaloric nutrition support from preoperative day 5 to postoperative day 7. Immune function was investigated including lymphocyte subsets, serum levels of immunoglobulins before and after operation. Prealbumin, transferrin, and albumin were determined as nutritional indicators. The recorded. Results Prealbumin level was significant higher resumption of gastrointestinal functions were observed and in the immunonutrition group than that in the control group on postoperative day 7 （P 〈 0.05）. CD4/CD8 ratio and IgG levels in the immunonutrition group were higher than those in the control group on postoperative day 7 （P 〈 0.05）. The gastrointestinal functions resumed earlier in the study group than in the control group. Conclusion Perioperative administration of enteral immunonutrition in gastric cancer patients can ameliorate the host immune function, improve nutritional status and recovery of intestinal function.

关 键 词：肠内营养 胃癌 免疫营养 

分 类 号：R735.2[医药卫生—肿瘤]