早期肠内营养支持对结直肠癌根治术患者免疫功能的影响

The effect of early enteral nutrition support on immune function in patients with postoperative colorectal cancer

目的探讨不同营养支持对结直肠癌患者恢复的影响。方法纳入我院2013年1月1日至2015年1月1日收治的80例结直肠癌患者,采用随机数字表法将患者分为早期肠内营养组(A组)和早期肠外营养组(B组)各40例。比较两组患者胃肠道功能恢复时间、免疫功能、术后感染发生率、不良反应。结果早期肠内营养组第一次排气时间、第一次排便时间短于早期肠外营养组,差异有统计学意义(P<0.01)。术后两组相比淋巴细胞数、中性粒细胞数、CD_4^+/CD_8^+差异均有统计学意义(P<0.05),其中早期肠内营养组淋巴细胞数、CD_4^+/CD_8^+高于早期肠外营养组。早期肠内营养组患者发生术后感染4例,发生率为10.0%;早期肠外营养组患者发生术后感染9例,发生率为22.5%。早期肠内营养组患者术后感染率显著低于早期肠外营养组,差异有统计学意义(P<0.05)。早期肠内营养组患者发生不良反应6例,发生率为15.0%;早期肠外营养组患者发生不良反应7例,发生率17.5%,不良反应率差异无统计学意义(P>0.05)。结论早期肠内营养支持可以更好的促进肠功能的恢复,减轻免疫抑制,降低术后感染率,对于结直肠癌根治术患者是一种适宜的营养支持方案。

Objective To investigate effect of different nutritionalsupport on immune function in patients with postoperative colorectal cancer. Methods January 1,2013-January 1,2015,80 patients included in our hospital were randomly divided into early enteral nutrition group（n= 40} and early parenteral nutrition group（ n= 40）. Comparison of gastrointestinal function recovery time, immune function, postoperative in- fection rate,adverse reaction. Results ：The first exhaust time, first defecation time of early enteral nutrition group is shorter than than in early parenteral nutrition group,the difference was statistically significant（ P〈0.01）. Comparison of lymphocyte count,neutrophil count, CD4＋/ CDS＋ between two groups, the difference was statistically significant（ P d0.05 ）. 4 cases in early enteral nutrition group who developed postoperative infection, the incidence rate was 10.0% ;9 cases in early parenteral nutrition group who de- veloped postoperative infection, the incidence rate was 10.0 % ; the difference was statistically significant （ P d0.05）. 6 cases in early enteral nutrition group who developed adverse reaction, the incidence rate of ad- verse reaction was 15.0% ;7 cases in early parenteral nutrition group who developed adverse reaction, the incidence rate was 17.5 ~//00 ;the difference was statistically significant（ P d0.05 ）. Conclusion ：Early enteral nutrition is a suitable method of nutritional support for colorectal cancer patients,it can promote the recov- ery of intestinal function,reduce immunosuppression,reduce postoperative infection rate.