食管癌患者围手术期肠内营养支持对术后免疫功能的影响  

Influence of perioperative enteral nutrition in patients with esophageal carcinoma on postoperative immune function

作　　者：曾贵青[1] 吕文强[1] 张志锋[1] 吴伟斌[1] 

机构地区：[1]揭阳市人民医院胸心外科,广东揭阳522000

出　　处：《包头医学院学报》2017年第3期36-37,共2页Journal of Baotou Medical College

摘　　要：目的:探讨食管癌患者围手术期肠内营养支持对术后免疫功能的影响。方法:选取2010年到2016年就诊的食管癌患者234例,随机分为观察组(121例)和对照组(113例),观察组患者在术前3 d和术后采用肠内营养治疗,同时联合肠外营养治疗;对照组患者则采用单纯的肠外营养的治疗方法,观察两组患者术前、术后1 d和8 d的免疫球蛋白A(immunoglobulin A,IgA)、IgG、IgM以及α-抗胰蛋白酶、C反应蛋白(C-reaction protein,CRP)水平。结果:术前两组患者的体液免疫学指标水平均无明显差异(P>0.05);术后1 d两组患者的体液免疫学指标下降幅度无明显差异(P>0.05);术后8 d,观察组患者的体液免疫学指标明显优于对照组(P<0.05);术前和术后1 d两组患者的CRP和α-抗胰蛋白酶均无差异(P>0.05);术后8 d观察组患者的CRP和α-抗胰蛋白酶比对照组低(P<0.05)。结论:肠内营养支持术使食管癌患者的免疫功能有明显的提高,手术后的各种炎症反应都有所缓解,更有利于患者术后的病情恢复,在临床治疗中可积极推广。Objective：To probe into the influence of perioperative enteral nutrition in patients with esophageal carcinoma on postoperative im- mune function. Methods：234 patients with esophageal cancer hospitalized from 2010 to 2016 were chosen and randomly divided into the observation group （ n = 121 ） and the control group （ n = 113 ）. The observation group was treated with enteral nutrition before the treatment for 3d and after treatment and was further treated with parenteral nutrition while the control group was treated with parenteral nutrition only, the immunoglobu- lin A （IgA） , lgG, IgM and alpha trypsin resistance and the C - reactionprotein （CRP） levels observed ld and 8d before and after operation. Re- suits：There was no significant difference in humoral immunological indices between the two groups before operation（ P 〉0.05 ） ; there was no sig- nificant difference in decrease of hurnoral immunology indices between the two groups （ P 〉 O. 05 ） 1 d after operation. The humoral immunology in- dex in the observation group was significantly better than that of the control group 8d after operation （ P 〈0.05 ） ; there was no significant differ- ence in CRF and alpha anti trypsin ld before and after operation between the two groups（ P 〉0.05） ; the CRP and alpha trypsin in the observation group were lower lhan those in the control group 8d after operation （ P 〈0. 05 ）. Conclusion：The enteral nutrition support can significantly improve the immune function of patients with esophageal cancer and all kinds of inflammatory responses were relieved after operation, which is con- ducive to postoperative recovery of patients and worth promoting clinically.

关 键 词：食管癌患者 肠内营养 免疫功能 

分 类 号：R735.1[医药卫生—肿瘤]