食管癌术后早期肠内营养对肠黏膜屏障功能及免疫功能的影响

Effects of early enteral nutrition on gut mucosal barrier and immune function in patients after esophagectomy

目的探讨早期肠内营养对食管癌术后患者肠屏障功能和免疫功能的影响。方法120例食管癌患者随机分为肠内营养（EN）组，肠外营养（PN）组，观察两种营养方法对肠黏膜屏障及免疫功能的影响。结果EN组术后第8天营养状态指标显著高于PN组。肠黏膜屏障功能指标显著优于PN组。炎性介质水平明显低于PN组。细胞免疫活性明显高于PN组。EN组血液、肺部、肠道等处感染率低。结论与PN相比，食管癌术后早期施行EN可更有效地改善术后患者的营养状态，促进肝功能的恢复，能有效地保护肠黏膜屏障功能，有效地减轻术后机体炎症反应，提高患者机体免疫功能，EN可减少术后感染并发症的发生。

Objective To evaluate effects of early enteral nutrition on gut mucosal barrier and immune function in patients after esophagectomy. Methods A randomized controlled clinical trial was conducted comparing the role of early enteral nutrition（EN） with parenteral nutrition（PN） in 120 patients after esophagectomy. The effects of EN and PN on gut mucosal barrier and immune function were observed. Results The level of nutrition indicators in the group of EN was higher than that in the PN group on the eighth day after operation. The indicators of gut mucosa barrier of the EN group were significantly lower than those of the PN group. Parameters of inflammatory mediators were significantly different between EN and PN group. Parameters of immune function were significantly different between EN and PN group. The infection rates of blood, lung and gut tract in EN group were lower than those in the PN group. Conclusion Campared with PN support, early EN support can more efficiently ameliorate the nutrition state of the pa- tients receiving esophagectomy, and accelerate the recovery of liver function. EN could protect gut barrier function and relieve the postoperative inflammatory reaction obviously. It can improve immune function and reduce the rate of postoperative infection.