早期低热量肠内外营养对胃癌术后免疫功能和炎症反应的影响

Effect of early hypocaloric enteral or parenteral nutrition support on immunological function and phlogistic response in postoperative patients with gastric cancer

目的 比较胃癌术后早期低热量肠内外营养支持对胃癌术后免疫功能和炎症反应的影响。方法 12 3例可切除胃癌病人按住院号末位奇偶数随机分成A、B两组。A组 6 7例术后第 2天开始接受低热量肠内营养。B组 5 6例术后第 2天开始早期接受低热量肠外营养。比较两组免疫指标和C反应蛋白 (CRP)的变化。结果 与B组相比 ,A组术后血IgA、IgG、IgM下降较少 (P <0 .0 5 ) ,而CD3 和CD4/CD8在A组更易恢复至术前水平 (P <0 .0 5 )。两组的血清CRP变化在术后第 4天无显著差异 (P >0 .0 5 ) ,而在术后第 8天 ,A组血清CRP下降明显 (P <0 .0 1)。结论 早期低热量肠内营养支持有利于胃癌术后免疫功能和炎症反应的改善。

Objective To evaluate the effect of early hypocaloric enteral nutrition(HEN) and parenteral nutrition (HPN) support on postoperative immunological function and phlogistic response in patients with gastric cancer.Methods\ One hundred and twenty three postoperative patients with gastric cancer were distributed into A and B groups randomly, according to their odd or even number in hospital. Group A (n=67) received early postoperative HEN from the second day after operation, while group B (n=56) received early postoperative HPN. Markers of immune and C reaction protein (CRP) in both groups were measured. Results The level of serum IgA, IgG and IgM in group A were significantly higher than that in group B (P<0.05); There was no significant difference between group A and B in serum CRP at the 4th day after operation (P>0.05), but there was a significant difference at the 8th day after operation (P<0.01).Conclusion Early HEN benefits the improvement of postoperative immunological function and phlogistic response in the patients with gastric cancer.