早期肠内营养对严重腹部创伤术后免疫功能的影响

Effect of early enteral nutrition on immune function of the patients after operation for severe abdominal trauma

目的观察早期肠内营养(enteralnutrition,EN)对严重腹部创伤术后免疫功能的影响。方法选择40例严重腹部损伤患者作为研究对象,随机分成EN组与肠外营养(parenteralnutrition,PN)组(PN组),每组20例。EN组术后12h经造瘘管给予营养液;PN组术后按常规,营养支持共7d。两组患者分别于术前和术后第1、第8天测定补体C3、免疫球蛋白(Ig)A、IgM、IgG和CD3+、CD4+、CD8+及CD4+/CD8+,并观察感染率的变化。结果7d后EN组补体C3、IgA、IgG、CD4+及CD4+/CD8+的恢复程度与PN组比较,差异有统计学意义;EN组感染率(10.0%)较PN组低。结论严重腹部创伤术后早期肠内营养有利于改善免疫功能,可降低患者术后感染率。

Objective To determine the effect of early enteral nutrition （EN） on immune function of the patients after operation for severe abdominal trauma. Methods Fourty patients who underwent operation for severe abdominal trauma were randomly divided into two groups, and received an early enteral nutrition （EN group, n = 20） through jejunal nutritional tube from postoperative day 1, or parental nutrition （PN group, n = 20） for 7 days. C3, IgA, IgM, IgG and CD3 ^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋ of the two groups patients were detected on the day before operation and the postoperative day 1 and 8. The infection complications were compared. Results After 7 days, the levels of C3, IgA, IgG, CD3^＋, CD4^＋, CD8^＋, and CD4^＋/CD8^＋ in EN group increased significantly compared with those in PN group （P 〈 0.05） . The incidence of infection was 10% in EN group, while 30% in PN group（ P 〈 0.05） . Conclusion Early enteral nutrition can improve immune function and decrease postoperative infection after operation for severe abdominal trauma.