免疫增强型肠内营养对老年胃肠道恶性肿瘤患者术后免疫功能的作用

The effect of postoperative immune - enhancing enteral nutrition on immune function in elderly patients with gastrointestinal cancer

目的：研究免疫增强型肠内营养对老年胃肠道恶性肿瘤患者术后免疫功能的影响。方法：选择老年胃肠道恶性肿瘤限期手术病人30例．随机分为使用免疫增强型肠内营养制剂的试验组和使用常规型肠内营养制剂的对照组，两组均于术后第一天起自营养管给予等热量、等氮量的肠内营养制剂，共7d。于术前、术后1、9d检测外周血T淋巴细胞亚群（CD3、CD4、CD8、CD4／CD8）；血清免疫球蛋白A、G、M（IgA、IgM、IgG）的浓度。并观察肠内营养副反应及疾病预后。结果：两组病人术后第1天所有指标均下降，术后第9天又明显回升，并高于术前水平（除CD8以外）．两缓比较（除IgM和CD8以外）差异有显著性意义（P〈0．05），试验组术后并发症发生率为13．3％，对照组为33．3％，两组比较差异有显著意义（P〈0．05）。结论：老年胃肠道恶性肿瘤患者术后早期给予免疫增强型肠内营养支持是安全可靠的，并可促进患者免疫功能恢复，有效改善疾病预后。

Objective To evaluate the effect of postoperative immune -enhancing enteral nutrition support on immune function in elderly patients with gastrointestinal cancer. Methods 30 elderly patients with gastrointestinal cancer were randomly divided into traditional enteral nutrition group and immune - enhancing enteral nutrition gmup. From the first day to the seventh day after operation, the two groups were supplied with same calorie and nitrogen nutritional treatment. The level of CD3 ,CD4 、CD8、CD4/CD8 and IgA,lgM,IgG were measured preoperatively and on day 1 and day 9 after operation. Side effect of enteral nutrition support and complications were also observed in two groups. Results All the levels of immune function were decreased on the postoperative day 1 in two groups. And all the level were increased in both groups on postoperative day 9 except IgM and CD8, but there was significant difference between two groups （P 〈 0.05 ）. The rate of complication in immune - enhancing enteral nutrition group was lower than that in traditional enteral nutrition group, there was also significant difference between two groups （ P 〈 0.05 ）. Conclusion Early of postoperative immune - enhancing enteral nutrition support in elderly patients with gastrointestinal cancer is safe, and the treatment could improve the immune function and prognosis.