肠内营养对肠道恶性肿瘤老年患者术后免疫功能及肠功能恢复的影响

The clinical effects of enteral nutrition on postoperative immune function and bowel function recovery in elderly patients with intestinal malignant tumor

[目的]探讨肠内营养应用在肠道恶性肿瘤老年患者中的治疗效果和临床价值。[方法]选择在我院行手术治疗的肠道恶性肿瘤老年患者108例,随机分为观察组和对照组,对照组术后给予肠外营养,观察组采用肠内营养支持,观察2组术后免疫功能以及胃肠功能恢复情况。[结果]与对照组比较,观察组术后第7天CD4+(34.08±8.17)%、CD8+(25.98±7.21)%、CD4+/CD8+(1.49±0.41)回升较对照组明显,组间比较差异有统计学意义(t=2.0206、2.2346、2.9389,均P<0.05)。观察组术后IgA(3.61±0.97)IU/ml与对照组术后IgA(2.01±0.71)IU/ml比较,差异有统计学意义(t=9.7810,P<0.05)。观察组肛门或造口排气时间(1.47±0.42)d,拆线时间(8.16±1.32)d、住院时间(18.64±2.88)d、发生感染3例,上述指标同对照组比较差异有统计学意义(t或χ2=7.9550、5.1669、8.9172、5.2523,均P<0.05)。[结论]肠内营养应用在肠道恶性肿瘤老年患者中可以改善患者术后免疫功能状态,缩短患者肛门或造口排气时间、拆线时间和住院时间,降低感染发生率,值得在临床上推广使用。

[Objective]To discuss the effects and clinical value of enteral nutrition in elderly patients with intestinal malignant tumor. [Methods]One hundred and eight patients with intestinal malignant tumor who underwent surgery in our hospital were enrolled in the study and randomized into observation group and control group. Patients in control group were given postoperative parenteral nutrition,while patients in observation group were given enteral nutrition support. Postoperative immune function and gastrointesti- nal function recovery in both groups were observed. [Results]The level of CD4＋ T cells 7 days after the surgery was（34. 08 ± 8.17）, CD8＋ T cells was （25.98 ±7.21 ）, CD4＋/CD8＋ was （ 1.49 ± 0.41 ） in observation group. Compared to control group, the increase of the above indexes in observation group was more obvi- ous than control group, and the difference was statistically significant （P〈0.05）. Postoperative level of IgA was（3. 61±0.97）in observation group and （2.01±0. 71）in control group. The difference between the two groups was statistically significant（t= 9. 7810, P〈0.05）. There were significant differences in the fol- lowing aspects between the two groups, such as colostomy anus exhaust time,suture removal time,length of hospital stay, and infection. [Conclusion]Enteral nutrition in elderly patients with intestinal malignant tumor can improve postoperative immune function,shorten suture removal time or colostomy anus exhaust time, and length of hospital stay, reduce infection, which is worth wide clinical application.