早期肠内营养对胃癌根治术后患者机体恢复及免疫功能的影响

Clinical Observation of Immune Response to Early Internal Nutrition after the Gastrectomy with Gastric Cancer

目的分析早期肠内营养对胃癌根治术后患者机体恢复及免疫功能的影响。方法将2012年3月至2013年3月于陕西省渭南市中心医院行胃癌根治术（D2）的41例胃癌患者采用随机数字表法分为两组：观察组（21例）行早期肠内营养支持治疗，对照组（20例）行静脉营养支持治疗。观察记录两组患者干预前后的机体恢复及免疫功能情况。结果观察组术后〈24h及24—36h的肛门排气率均高于对照组（P〈0．05），并发症发生率低于对照组（P〈0．05）；两组患者经营养治疗后血清白蛋白、前白蛋白、转铁蛋白较术前有显著改善（P〈0．05），但组间比较差异无统计学意义（P〉0．05）；观察组患者术后CD3^＋、CD4^＋、CD8^＋和CD4^＋／CD8^＋比值均较术前显著改善（P〈0．05），且与对照组比较差异有统计学意义（P〈0．05）。结论早期肠内营养对胃癌根治术患者术后机体恢复促进作用较大，可显著改善患者免疫功能，促进患者胃肠恢复。

Objective To observe the clinical therapeutic effect of immune response to early internal nutrition after the gastrectomy with gastric cancer. Methods 41 cases with gastric cancer after gastrectomy admitted to the Central Hospital in Weinan City from March 2012 to March 2013 were randomly divided into observation group （21 cases）and control greup（20 eases）. The observation group were treated with early internal nutrition and the control group were treated with conventional nutritional treament. The patients were compared recovery of intestinal function. Results The anal exhaust rate of observation group at 〈 24h and 24 to 36h were higher than those of control group （ P 〈 0.05 ） ,incidence of complications was lower than that of control group（P 〈0.05） ;ALB,PA and TFN level significantly improved as compared to those preoperatively in two groups （ P 〈0.05 ）, but there was no statistical difference between two groups （ P 〉 0.05 ） . On day 7 postoperatively ,the CD3^＋,CD4^＋,CD8^＋ and CD4^＋/CD8^＋ levels in the observation group and control group were significantly improved compared with before treatment, especially in the observation group, with significant differences between two groups after treatment （ P 〈 0.05 ）. Conclusion Early internal nutrition brings up a quicker recovery and a lesser depression to the immune system and worthy of clinical application.