大肠癌术后早期营养支持对免疫功能的影响  

Early Changes in Immunity after Postoperative Parenteral Nutrition in Colon or Rectum Cancer Patients ( An Analysis of 60 Cases)

作　　者：刘凯[1] 刘文方[1] 范跃祖[1] 王宝昌[1] 蔡同年[1] 

机构地区：[1]同济大学附属同济医院普外科,上海200065

出　　处：《同济大学学报（医学版）》2001年第4期37-38,42,共3页Journal of Tongji University(Medical Science)

摘　　要：目的　研究大肠癌术后肠外营养支持早期机体免疫功能的变化。方法　对 6 0例大肠癌病人根治术后 ,随机分为试验组 (TPN组 )和对照组 (非TPN组 )。分别于手术前 ,术后 1d及术后 8d检测IgG、IgA、IgM、C3、T细胞亚群。结果　大肠癌病人术前均有不同程度的免疫功能低下 ,术后第 1天 ,IgG、IgA、IgM、C3 较术前显著下降 ,术后 8dTPN组IgG、IgA、C3 恢复较快 ,达到或超过术前水平 ,与非TPN组比较差异有显著意义 (P <0 .0 1)。CD+ 3 、CD+ 4、CD+ 4/CD+ 8比值术后第 1天下降明显 ,而TPN组术后 8d迅速恢复并超过术前水平 ,与非TPN组相比差异有显著意义 (P <0 .0 1)。结论　大肠癌病人术后早期免疫功能低下 。Objective To study the early changes in immunity after postoperative nutrition in colon or rectum cancer patients.Methods 60 patients with colon or rectum cancer were divided into two groups at random, namely TNP group and control group. On day 1 before operation, day 1 after operation and day 8 after operation, IgG, IgA, IgM, C 3, T-Cell subgroups were detected.Results The immune function of patients with colon or rectum cancers was deficient at different levels. On day 1 after operation, IgG, IgA, IgM, C 3 decreased more significantly as compared with those before operation. On day 8 post operation, IgG, IgA, C 3 of TPN group recovered rapidly and might reach or exceed the preoperative levels. Compared with non-TPN group, the difference was significant ( P< 0.01). CD + 3, CD + 3, CD + 4/CD + 8 ratio decreased significantly on day 1 post operation, but in TNP group, they recovered rapidly and exceeded the preoperative level, the difference between them being significant ( P< 0.01).Conclusion The early immune function of patients with colon or rectum cancer is deficient after operation, and the use of TNP can improve immune function of patients.

关 键 词：大肠肿瘤 胃肠外营养 免疫功能 TPN 

分 类 号：R735.34[医药卫生—肿瘤] R459.3[医药卫生—临床医学]