ω-3多不饱和脂肪酸早期肠内营养对结直肠癌患者术后营养和免疫功能的影响

Effect of early enteral nutrition with ω-3 polyunsaturated fatty acid on nutritional status and body immunity of postoperative patients with colorectal cancer

【摘要】目的探讨添加ω-3多不饱和脂肪酸的早期肠内营养（EEN）对结直肠癌患者术后营养状态和免疫功能的影响。方法选择40例实施结直肠癌根治术患者，采用机械抽样法随机分为EEN组和肠外营养（PN）组，每组20例。EEN组术后1—7d给予肠内营养乳剂（含ω-3多不饱和脂肪酸），PN组术后常规全静脉营养支持。观察两组患者术前和术后1、7d的营养指标、免疫指标及肠功能恢复、不良反应情况。结果EEN组肛门排气时间、排便时间分别为（48．0±5．6）、（53．0±4．8）h，均短于PN组的（51．0±6．7）、（72．0±3．6）h，差异有统计学意义（P〈0．05）。两组术后1d血清白蛋白（ALB）、前白蛋白（PA）均较术前明显下降，术后7d血清ALB、PA均较术后1d明显升高，差异均有统计学意义（P〈0．05）。EEN组术后7d血清ALB、PA较PN组明显升高，差异有统计学意义（P〈0．05）。两组术后1dIgG、IgA、IgM、CD3、CD4、CD8、CD4／CD8均较术前下降，差异有统计学意义（P〈0．05）。EEN组术后7dIgG、IgA、C04、CDJCD8较PN组明显升高，差异有统计学意义（P〈0．05）。结论添加ω-3多不饱和脂肪酸的EEN能改善结直肠癌患者术后营养状态和免疫功能，有利于患者恢复，值得临床推广应用。

Objective To study the effect of early enteral nutrition （EEN） with co-3 polyunsaturated fatty acid on nutritional status and body immunity of postoperative patients with colorectal cancer. Methods Foity patients with colorectal cancer were randomly divided into EEN group and parenteral nutrition （PN） group by systematic sampling method with 20 cases of each. The patients in EEN group were given complete enteral nutrition with co-3 polyunsaturated fatty acid 1 - 7 d after operation,while the patients in PN group only were given nutrient by regular PN. Nutritional status,body immunity before operation and 1 - 7 d after operation,and intestinal function recovery time, untoward reaction were determined. Results The postoperative anus first exhaust time and defecate time of patients in EEN group were significantly shorter than those in PN group [ （48.0 ＋ 5.6） h vs. （51.0 ＋ 6.7） h, （53.0 _＋ 4.8） h vs. （72.0 -＋ 3.6） h, P 〈 0.05 ]. Serum albumin and prealbumin 1 d after operation in 2 groups were significantly lower than before operation （P 〈0.05）,but 7 d after operation were significantly higher than 1 d after operation （P 〈0.05）. Serum albumin and prealbumin 7 d after operation in EEN group were significantly higher than PN group（P 〈 0.05 ）. IgG, IgA, IgM, CD3, CD4, CDs, CD4/CD8 1 d after operation in 2 groups were significantly lower than before operation （P 〈 0.05 ）. IgG, IgA, CD4, CDJCDs 7 d after operation in EEN group were significantly higher than PN group （P 〈 0.05 ）. Conclusions Compared with the PN, EEN with to -3 polyunsaturated fatty acid can remarkably improve nutritional status and body immunity in postoperative patients with colorectal cancer. It can accelerate the recovery of intestine function and worthy of recommending.