摘要
目的探讨消化道恶性肿瘤术后早期肠内营养(EEN)+肠外营养(PN)可行性,并将其与完全胃肠外营养(PN)对患者营养状况和免疫功能的影响进行比较。方法将2002年10月-2004年3月在本院普外科行择期消化道恶性肿瘤手术患者随机分为EEN+PN组(22例)和TPN组(24例),于术后24h开始营养治疗。术前、术后第1、3、7天测定血前白蛋白(PA)、白蛋白(ALB)和血色素(Hb)水平;术前、术后第7天测定血IgA、IgG、IgM、T淋巴细胞亚群CD3、CD4、CD8及CD4/CD8水平;术后第1～7天每日测定氮平衡(NB)。比较两组上述指标在术后的差异。结果两组间在术前、术后第1、3、7天测定的血PA、ALB、Hb及术后第1-7天测定的NB比较,差异均无显著性(P>0.05)。术后第7天EEN+PN组CD3、CD4水平明显高于TPN组(P<0.05,P<0.01)。结论EEN+PN是腹部术后安全有效的营养途径。由于EEN+PN在改善免疫功能方面明显优于TPN,因此它应成为消化道肿瘤患者术后首选的营养方式。
Objective To investigate the feasibility of early postoperative enteral nutrition （EEN）plus parenteral nutrition after operation of gastrointestinal malignant tumors and compare the nutritional status and immmunologic function between the EEN and total parenteral nutrition （TPN）. Methods From October 2002 to March 2004,46 cases received gastrointestinal operation were randomly divided into two groups,namely EEN plus PN group（22 cases） and TPN group（24 cases）. The nutritional therapy was started after operation 24 hours.The nutritive index and immunologic function index werer compared between the both groups during pre-operation and postoperation. Results There was no significant difference between the both groups in the mention above two indexes during preoperation and postoperation （P 〈0.05）.However, in the CD3 and CD4 of T lymphocyte subsets,the EEN plus PN group was significantly higher than that TPN group on the 7th day after operation（P〈 0.05, P〈 0.01）.Conclusion EEN plus PN are safe and effective nutritional pathway after abdominal operation.Because of EEN plus PN is much superior to PN in improving immunologic function,so,it is a first choice of postoperative nutritional manner for patients with gastrointestinal malignant tumors.
出处
《岭南现代临床外科》
2005年第2期122-125,共4页
Lingnan Modern Clinics in Surgery
关键词
肠内营养
肠外营养
免疫
手术
Enteral nutrition
Parenteral nutrition
immunity
Operation
