胃肠道恶性肿瘤术后病人应用免疫增强型肠内营养的临床研究

A clinical study on applying immunoenhancement type enteral nutrition for postoperative gastrointestinal tract malignant tumor patients

[目的]研究胃肠道恶性肿瘤术后病人应用免疫增强型肠内营养的疗效。[方法]随机选择胃肠道恶性肿瘤术后病人53例,分为试验组和对照组。术后第1天至第8天,试验组和对照组分别输注免疫增强型肠内营养制剂及常规肠内营养制剂。观察病人一般情况、副反应及感染性并发症的发生情况,手术前及术后第1天、第8天采集外周血,分别测定IgG、IgA、IgM、T淋巴细胞亚群(CD3、CD4、CD4/CD8比值)及C反应蛋白(CRP)、前列腺素E2(PGE)、α-抗胰蛋白酶,同时测尿中乳果精和甘露醇的比值(L/M)。[结果]与对照组相比,试验组在术后第8天IgG、IgA、IgM、CD3、CD4、CD4/CD8比值明显增高(P<0.05),CRP、PGE、α-抗胰蛋白酶明显降低(P<0.05),两组一般情况、并发症、L/M差异无统计学意义。[结论]胃肠道恶性肿瘤病人术后应用免疫增强型肠内营养制剂安全有效,可改善病人的免疫功能和预后。

Objective：To study on the curative effect of applying immunoenhancement type enteral nutrition for postoperative gastrointestinal tract malignant tumor patients. Methods-A total of 53 postoperative gastrointestinal tract malignant tumor patients were randomly selected and divided into test and control group. From the first postoperative day to the eighth day,immunoenhancement type enteral nutrition preparation and routine enteral nutrition preparation were respectively infused for test group cases and control group patients. General condition,adverse reactions and infectious complications of all patients were observed. The peripheral blood of patients before operation, on the postoperative first day and the eighth day were collected respectively and IgG, IgA, IgM, T lymphocyte subgroup CD3 ,CD4 ,the ratio of CD4/CD8 and CRP,PGE and α- antitrypsin were determined. Meanwhile,the ratio of lactose and mannitol （L/M） in urine of all cases were detected. Results：Compared with control group cases, blood IgG, IgA, IgM, CDa, CD4, and the the eighth postoperative day were value of CD4/CD8 of test group cases on remarkably higher（P〈0.05）. And blood CRP,PGE and α - antitrypsin of test group cases were significantly lower （P〈0.05）. However, there were no statistical significant differences in terms of general condition, complications, and the value of L/M in urine between the two groups. Conclusion： Applying immunoenhancement type enteral nutrition for postoperative gastrointestinal tract malignant tumor patients is safe and effective. It can improve the immune function and prognosis of patients.