不同营养方式对消化道恶性肿瘤术后免疫功能的影响

The effect of post operative different nutrition support method on immune function of patients with gastrointestional cancer

目的:研究不同营养方式对消化道恶性肿瘤术后免疫功能的影响。方法:41例消化道恶性肿瘤病人随机分成两组,术后分别接受肠内营养(EN)和胃肠外营养(PN),并于术前和术后第1天、第8天测定C3、IgA、IgM、IgG和CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞百分率,并观察肠蠕动恢复时间及感染率。结果:7d后EN组补体C3、IgA、IgG、CD4+、CD4+/CD8+、NK细胞的恢复程度与PN组差异有显著性;EN组住院时间缩短,感染率较PN组低。结论:与PN对比,EN能改善免疫功能、促进肠蠕动恢复,降低病人术后感染率,缩短住院时间。

Objective To study the effect of postoperative different nutrition support methods on immune function of patients with gastrointestional cancer. Methods Forty-one patients with gastrointestional cancer were choose, and receive operation therapy in our hospital. They were randomized to either enteral nutrition （EN） or parental nutrition （PN）. C3, IgA, IgM, IgG and CD3＋, CD4 ＋, CD8 ＋, CD4 ＋/CD8 ＋, NK cell of the two groups patients were detected on the day before the operation and the postoperative days 1 and 8. The restoring time of intestinal movement and infective complications were observed. Results Mter 7 days the changes of C3, IgA and IgG in EN group were significantly different from PN group （P〈0. 05）. And the changes of CD4 ＋, CD4 ＋/CD8 ＋, NK ceil in EN group were significantly different from PN group （P〈0.05 ）. The restoring time of intestinal movement was significantly decreased in the EN group （P〈0.05） compared with PN group after operation. The incidence of infective complications in EN group was 14. 28%, in PN group was 45.0% （P〈0.05）. The average days in hospital after operation was （13.2±4.2） d in EN group, and（18.3±3.9） d in PN group. Conclusions Compared with PN, EN can improve immune function, promote the recovery of intestinal function and decrease infection complications, shorten the average days in hospital after operation.