营养不良胃肠癌病人手术前行肠外营养支持的作用

Values of preoperative parenteral nutrtion in malnutrition gastrointestinal cancer patients

目的：探讨手术前肠外营养支持（ＰＮＳ）对营养不良胃肠癌病人的营养和免疫作用。方法：９例营养不良的胃肠癌病人，术前ＰＮＳ７～１０天，平均８．１天。营养物质采用全合一方式经锁骨下静脉持续输注，实验前后检测多项营养和免疫指标。结果：ＰＮＳ前后血清前白蛋白（ＰＡ）浓度差异显著（Ｐ＜０．０５）。ＰＮＳ前后外周血淋巴细胞总数、自然杀伤细胞活性及白细胞介素－２受体阳性细胞（ＣＤ２５）比率差异显著（分别Ｐ＜０．０５，Ｐ＜０．０１，Ｐ＜０．０５），其余免疫指标则差异不显著。

Objectives:To investigate the nutritional and immune effects of preoperative parenteral nutrition in malnutrition gastrointestinal cancer patients. Methods:Nine malnutrition patients with gastrointestinal cancer were studied.The patients entered the study received preoperative parenteral nutritional support (PNS) for 7￣10 days(mean 8.1 days).The nutrients were administered as all in one and continuous infused through an indwelling catheter placed in the subclavian vein.Nutritional and immunological parameters were monitored before and at the end of the study. Results:Serum prealbumin concentraton increased significantly( P <0.05) at the end of preoperative PNS.Total lymphocyte count,natural killer cells activity and IL 2R + cells(CD 25 ) percentage of peripheral blood also increased significantly ( P <0.05, P <0.01, P <0.05,respectively).There were no significant changes in the other immunological parameters. Conclusions:The nutritional and immune status of the malnutrition patients with gastrointestinal cancer might be improved by preoperative PNS.