胃癌根治术后行早期肠内免疫营养支持促进机体胃肠、免疫功能恢复的临床研究

Early enteral immune nutrition support after radical operation for gastric cancer on promoting recovery of gastrointestinal function and immune function

目的:分析胃癌根治术后行早期肠内免疫营养支持对机体胃肠、免疫功能恢复的影响。方法:选择106例在本院行胃癌根治术治疗的患者作为研究对象,根据术后营养干预方式不同,分为观察组(n=50)、对照组(n=56)。对照组接受常规肠内营养干预,观察组接受术后早期肠内免疫营养支持,对比两组术后肠黏膜屏障功能、胃肠激素水平、免疫功能水平、营养相关指标值等差异。结果:观察组经肠内免疫营养干预后,血清二胺氧化酶(DAO)、脂多糖(LPS)、D-乳酸水平,尿中乳果糖/甘露醇比值(L/M)均低于对照组(P<0.05);观察组干预后血清促胃液素(GAS)、胆囊收缩素(CCK)、胃动素(MTL)、P物质(SP)值高于对照组,促胰液素族(GLU)、血管活性肠肽(VIP)、肠抑胃肽(GIP)、生长抑素(SS)值低于对照组(P<0.05);观察组干预后CD4、IgG、NK细胞、C3、C4、总补体活性(CH50)、分泌型免疫球蛋白A(S-IgA)水平均高于对照组(P<0.05);观察组干预后血清白蛋白(ALB)、前白蛋白(PRE)、转铁蛋白(TRF)、视黄醇结合蛋白(RBP)水平均高于对照组(P<0.05)。结论:胃癌根治术后行早期肠内免疫营养支持,有助于胃肠道功能的恢复及免疫状态提升,最终促进患者的术后整体康复,具有积极的临床意义。

Objective：To analyze the effect of early enteral immune nutrition support after radical operation for gastric cancer on the recovery of gastrointestinal function and immune function.Methods：A total of 106 cases of patients who received radical operation for gastric cancer in our hospital were selected as research subjects,and according to different ways of postoperative nutrition intervention,all patients were divided into observation group（n=50）and control group（n=56）.Control group received conventional enteral nutrition intervention,observation group received postoperative early enteral immune nutrition support,and then differences in postoperative intestinal mucosa barrier function,gastrointestinal hormone levels,immune function levels and nutrition-related indicator values were compared between two groups.Results：After observation group received enteral immune nutrition intervention,serum diamine oxidase（DAO）,lipopolysaccharide（LPS）and D-lactate levels as well as urine lactulose/mannitol（L/M）ratio were significantly lower than those of control group（P〈0.05）;serum gastrin（GAS）,cholecystokinin（CCK）,motilin（MTL）and substance P（SP）values of observation group after intervention were significantly higher than those of control group,and GLU,VIP,GIP and SS values were significantly lower than those of control group（P〈0.05）;CD4,IgG,NK cell,C3,C4,complement hemolysis 50%（CH50）and secretory immunoglobulin A（SIgA）levels of observation group after intervention were significantly higher than those of control group（P〈0.05）;serum albumin（ALB）,prealbumin（PRE）,transferrin（TRF）and retinol binding protein（RBP）levels of observation group after intervention were significantly higher than those of control group（P〈0.05）.Conclusion：Early enteral immune nutrition support after radical operation for gastric cancer is conducive to the recovery of gastrointestinal function and the promotion of immune state,eventually promotes patients＇ postoperative overall recovery and has active clinical significance.