早期肠内营养对胃癌患者根治术后临床结局的影响

Influence of Early Enteral Nutrition on Postoperative Clinical Effects of Gastric Cancer Patients Treated with Radical Operations

目的探讨早期肠内营养对胃癌根治术患者术后临床结局的影响。方法将经胃癌根治术治疗的胃癌患者100例随机分为观察组与对照组,每组50例。对照组患者术后采取肠外营养治疗,观察组患者术后采取早期肠内营养治疗。观察并比较2组患者治疗后的临床结局,并对2组患者术后免疫功能及营养状况进行评价。结果观察组患者术后发热时间、肠功能恢复时间、排气时间、住院时间均明显短于对照组;2组患者术后第1天的CD3+、CD4+、CD4+/CD8+、NK各免疫细胞活性较术前均明显降低(P<0.05),而CD8+无明显降低,且组间比较无明显差异(P>0.05);经营养治疗后,观察组患者术后第7天的CD3+、CD4+、CD4+/CD8+、NK各免疫细胞活性分别为(35.6±4.2)%、(42.2±3.0)%、(1.72±0.27)%、(27.3±5.3)%,接近于术前水平,而对照组仍明显低于术前,且低于肠内营养组,P<0.05,具统计学意义。结论胃癌根治术患者早期肠内营养治疗后的临床结局较好,患者术后免疫功能及营养状况均明显改善,值得在临床上广泛应用。

Objective To investigate the influence of early enteral nutrition on gastric cancer patients after radical gas- trectomy. Methods 100 cases of gastric cancer patients were randomly divided into the observation group and the control group, 50 cases in each group. The control group received parenteral nutrition therapy, the observation group were treated with early en- teral nutrition therapy. The clinical outcomes of the 2 groups were observed and compared after treatment,, and postoperative im- mune function and nutritional status were evaluated. Results The time of postoperative fever, intestinal function recovery, ex- haust, and hospitalization of the observation group were significantly shorter than those of the control group ; CD3 ＋ , CD4 ＋ , CD4 ＋/CD8 ＋ , NK and various immune cells activity of the 2 groups first day after surgery were significantly lower than before the surgery （P 〈 0.05 ） , and CD8 ＋ had no significant decrease, there was no significant difference （P 〉 0.05 ） ;the CD3 ＋ , CD4 ＋ , CD4 ＋/CD8 ＋ , NK activity of various immune cells in the observation group after the first 7 days were （ 35.6 ± 4.2 ） % , （42.2 ±3.0 ） % , （ 1.72 ±0.27 ） %, （ 27.3 ±5.3 ） % , respectively, close to the preoperative levels, while the control group was still signif- icantly lower than before the surgery, and less than enteral nutrition group, P 〈 0.05, it was statistically different. Conclusion Early enteral nutrition in patients treated with radical gastrectomy has better clinical outcome, immune function and nutritional sta- tus of patients are significantly improved, it is worth of clinical application.