不同营养支持途径对老年消化道肿瘤病人术后营养免疫状况的影响

Effects of different nutritional support on nutritional status and immunal funct ion of elderly patients following surgery for digestive neoplasm of the digestiv e tract

目的 比较肠内(enteralnutrion,EN)、肠外营养(parenteralnutrition, PN)联合应用(EN+PN)和单用肠外营养(PN)对老年消化道肿瘤病人术后营养免疫状况的影响。方法 将40例老年消化道肿瘤病人随机分为肠内、肠外营养联合应用(EN+PN)组和肠外营养(PN)组,每组20例。术后第1天开始给予同热量、等氮量的营养支持一周,并检测术前和术后第8天营养指标、免疫指标。结果 两组病人术后第8天的体重均较术前下降,两组间无差异(P>0. 05),两组病人经营养支持后营养指标明显升高, (P<0. 05)。T淋巴细胞亚群在EN+PN组术后8天基本恢复到术前水平,而PN组与术前相比,尚有差异。结论 老年消化道肿瘤病人术后EN+PN或PN都能改善营养及免疫状态,EN+PN在提高机体免疫功能方面优于PN。术后早期EN是安全、可行和有效的。

Objective To evaluate the effects of enteral nutriti on (EN+PN) and parenteral nutrition(PN) on nutritional status and immunal function of elderly patients following surgery for tumors of the digestive tract. Methods Forty patients operated for tumor of alimentery tract were randomly divided into EN+PN group(n=20) and PN group( n=20).Equal calorie and nitrogen were given from the first day after opera tion and was maintained for one week. Parameters of nutritional and immunal stat uses were measured before and after nutritional support. Results Body weight decreased significantly in both groups, but without signi ficant difference (P<0.001) Nutritional markers significantly in creased after nutritional support was given(P<0.05).The indexes of immune function were improved significantly in EN+PN group. Concl usions Postoperative EN +PN or PN could improve nutritional and im munal status of elderly patients with digestive tract tumors.Improvement of immu nity was better in EN +PNgroup than in PN group. Early EN after surgery is safe , feasible and effective.