免疫肠内营养在高龄胃癌病人术后免疫调节作用的观察  

Investgation on the effects of postoperative enteral immunonutrition in elderly gastric cancer patients

作　　者：周斌[1] 朱海涛[1] 文旭[1] 李刚[1] 顾荣民[1] 明学志[1] 陈环球[1] 魏尉[1] 

机构地区：[1]江苏省肿瘤医院/南京医科大学附属肿瘤医院普通外科,江苏南京210009

出　　处：《肠外与肠内营养》2015年第6期325-328,共4页Parenteral & Enteral Nutrition

基　　金：江苏省卫计委保健科研项目(BJ14020)

摘　　要：目的:观察免疫肠内营养对高龄胃癌病人术后恢复、免疫功能、营养状况的影响。方法:将68例高龄胃癌病人(>70岁)手术后随机分为免疫肠内+肠外营养(EN+PN)组和肠外营养(PN)组。于术前1 d、术后第1和第7天检测相关的营养和免疫血清指标,观察术后恢复情况,并比较和分析。结果:两组病人术后第1天血清总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)、Ig G、Ig A水平以及CD3、CD4、CD4/CD8较术前1 d有显著下降。术后7天EN+PN组血清TP、ALB、PA、Ig G、Ig A以及CD3、CD4、CD4/CD8与PN组比有显著性差异(P<0.01)。术后EN+PN组和PN组发生术后并发症无显著性差异。结论:早期使用肠内免疫营养制剂,可改善高龄胃癌病人手术后的免疫功能和营养状态。Objective： To investgate the effects of enteral immunonutrition on recovery,nutritional status,immune function in elderly gastric cancer patients after gastrectomy. Methods： 68 cases of elderly gastric cancer patients postgastrectomy were randomly divided into total parenteral nutrition（ PN）group,enteral immunonutrition added parenteral nutrition（ EN ＋ PN） group. The recovery,serum marker on nutritional status and immune function were evaluated and compared before operation and on the 1st,7th day after operation. Results： The levels of serum total protein,albumin,prealbumin were significantly decreased in 2 groups on the 1st day after operation（ P〈0. 05）,and they were significantly increased（ P〈0. 05） in EN ＋ PN group on the 7th days after operation. The levels of serum Ig G,Ig A,T helper cells（ CD3＋,CD4＋） and ratio of CD4＋,CD8＋（ CD4＋/ CD8＋） were significantly decreased in 2groups on the 1st day（ P〈0. 05） after operation,and Ig G,Ig A,CD3＋,CD4＋and CD4＋/ CD8＋were significantly increased in EN ＋ PN group（ P〈0. 05） on the 7th day after operation. There were no significant difference in postoperative complication between 2 groups. Conclusion： Postoperative early usage of enteral immunonutrition can improve the nutritional status and enhance immunity in elderly gastric cancer patients.

关 键 词：免疫肠内营养 肠外营养 高龄胃癌 围手术期 

分 类 号：R459.3[医药卫生—治疗学] R735.2[医药卫生—临床医学]