不同营养方式对老年食管癌患者术后免疫功能的影响

Effects of different postoperative nutrition methods on cellular immunity of elder patients with esophageal cancer

目的探讨不同营养方式对老年食管癌患者术后免疫功能的影响。方法将72例老年食管癌患者随机分为2组:肠内营养(EN组)及肠外营养组(PN组),均于术后第1天开始营养支持,共实施8 d。2组病人分别于手术前1天、术后第1天、第8天检测体液免疫和细胞免疫指标的变化。结果术后第1天2组病人补体C3、补体C4、IgA、IgM、IgG水平和CD3+、CD4+、CD4+/CD8+比值均较术前1天下降(P<0.05),早期肠内营养组术后第8天CD3+、CD4+、CD8+、CD4+/CD8+和血清补体C3、C4、IgA、IgM、IgG水平等免疫指标迅速恢复,与完全肠外营养组比较差异有统计学意义(P<0.01)。结论老年食道癌术后患者行早期肠内营养支持耐受性好,更能改善患者的营养状况,对病人术后细胞免疫和体液免疫均有明显的增强作用。

To investigate the effects of different postoperative nutrition methods on cellular immunity of elder patients with esophageal cancer, seventy-two elder patients with esophageal cancer patients were randomly divided into enteral nutrition （EN） group and parenteral nutrition （PN） group. The patients in EN group received supportan enteral nutrition from postoperative day 1 to 8, while the patients in PN group received total parenteral nutrition. C3, C4, IgA, IgM, IgG, CD3＋, CD4＋, CD4＋/CD8＋ were detected on the day before the operation and the postoperative days 1 and 8. Results showed that all the levels of C3, C4, IgA, IgM, IgG, CD3＋, CD4＋, CD4＋/CD8＋ in two groups were decreased at postoperative day 1 as compared with the day before the operation. Until postoperative day 8, the levels of the indicators in the PN group had no significant change （P〉 0.05）, but in the EN group were significantly improved （P〈 0.05）, and demonstrated significantly different as compared with the PN group（P〈 0.05）. In conclusion, early enteral nutrition can improve the immunologic function after operation in patients with esophageal cancer, can decrease the infection rate.