全胃切除后早期肠内营养对肠黏膜屏障的影响

Influence of early enteral nutrition on intestinal mucosa barrier after total gastrectomy

目的:观察全胃切除术后早期肠内营养支持对肠黏膜屏障的保护效果。方法:将符合入选标准的29例全胃切除术后患者随机分为肠外营养(parenteral nutrition,PN)组及肠内营养(enteral nutrition,EN)组。两组患者术后第24 h开始至术后第8天接受等氮、等热卡的营养支持。观察患者血清免疫球蛋白及血清双胺氧化酶。结果:血清双胺氧化酶活性两组都下降,EN组术后第7天即恢复正常(P>0.05),而PN组第14天才恢复正常(P>0.05)。EN组营养支持后IgA水平均显著高于术前和PN组术后(P<0.01)。结论:全胃切除术后,早期肠内营养治疗可以保护肠黏膜的完整性和肠道的免疫屏障。

Objective ：To investigate the effect of early postoperative enteral nutrition （EN） on the function of intestinal mucosa after total gastrectomy. Methods：Twenty-nine patients undergoing total gastrectomy for gastric cancer were randomly divided into EN group and parenteral nutrition（PN） group. Both groups received the same amount of nitrogen and calorie from 24 hours to the eighth day after operation, and the serum level of peripheral immuinoglobulins and serum diamine oxidase （DAO） were measured. Results：DAO activity decreased in both groups. EN group recovered within 1 week but PN group did not recover until the 14th day. The level of IgA in EN group was significant higher than that in PN group as well as that of EN group before operation （P 〈 0.01 ）. Conclusions：Early EN can alleviate the immune suppression and preserve the integrity of intestinal mucosa barrier after total gastrectomy.