益生菌联合早期肠内营养对胃癌根治术患者炎症因子、细胞免疫及营养指标的影响  

Effects of probiotics combined with enteral nutrition on postoperative inflammatory factors cellular immune function and nutritional indexes in patients with gastric cancer undergoing radical operation

作　　者：李洲[1] 马勇[1] 方仕旭 徐琳[2] Li Zhou;Ma Yong;Fang Shixu;Xu Lin(Department of General Surgery,Zigong First People's Hospital,ZiGong 643000,Sichuan,China;Department of Gastrointestinal Surgery,Sichuan Cancer Hospital,Chengdu 610041,Sichuan,China)

机构地区：[1]自贡市第一人民医院普通外科,四川自贡643000 [2]四川省肿瘤医院胃肠外科,四川成都610041

出　　处：《肿瘤代谢与营养电子杂志》2023年第2期225-229,共5页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的观察益生菌联合早期肠内营养支持对胃癌根治术患者术后炎症因子、细胞免疫功能和营养指标的影响。方法选取2020年1月至2022年7月自贡市第一人民医院普外科行腹腔镜辅助胃癌根治术治疗患者134例,采用随机数字表法分为对照组采用早期肠内营养治疗(EENS)组,观察组采用益生菌联合早期肠内营养治疗(PEENS)组,各67例。对比两组患者治疗前、后炎症因子水平[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平]、细胞免疫功能水平(CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)/CD8^(+)水平)、营养指标水平(外周血白蛋白、总蛋白水平)及并发症发生情况。结果PEENS组治疗后的IL-2、IL-6及TNF-α水平均显著低于EENS组和治疗前(P<0.05);PEENS组治疗后的CD4^(+)T细胞和CD4^(+)/CD8^(+)水平均显著高于EENS组和治疗前,PEENS组治疗后的CD8^(+)T细胞水平均显著低于EENS组和治疗前(P<0.05);PEENS组治疗后的白蛋白和总蛋白水平均显著高于EENS组和治疗前(P<0.05);两组并发症总体发生率比较差异无统计学意义[5.97%(4/67)比7.46%(5/67),χ^(2)=0.199,P=0.730]。结论PEENS应用于胃癌根治术后患者,可有效减轻炎症反应水平、调节细胞免疫功能和改善营养状态。Objective To observe the effect of probiotics combined with enteral nutrition support on postoperative inflammatory factors,cellular immune function and nutritional indicators in patients with gastric cancer after radical operation.Method 134 patients with gastric cancer who underwent laparoscopic assisted radical gastrectomy in general surgery department of Department of General Surgery Zigong First People's Hospital from January 2020 to July 2022 were selected and randomly divided into control group(n=67)and observation group(n=67),The control group received early enteral nutrition support(EENS)group,and the observation group received probiotics combined with early enteral nutrition support(PEENS)group.The levels of inflammatory factors(IL-2,IL-6,TNF-α),cellular immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and nutritional indexes(albumin and total protein levels in peripheral blood measured by protein analyzer)and complications were compared between the two groups before and after treatment.Result After the intervention,the levels of IL-2,IL-6 and TNF-α in the observation group were significantly lower than those in the control group and before the intervention(P<0.05)^(+)/CD8^(+)levels were significantly higher than those in the control group and before intervention(P<0.05),CD8^(+)levels in the observation group after intervention were significantly lower than those in the control group and before intervention(P<0.05);albumin and total protein levels in the observation group after intervention were significantly higher than those in the control group and before intervention(P<0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Probiotics can effectively reduce the level of inflammatory response,protect cellular immune function and improve nutritional status in patients with early gastric cancer after operation.

关 键 词：胃癌 益生菌 早期肠内营养支持 炎症因子 免疫功能 营养 

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