肠内营养对胃恶性肿瘤患者术后免疫功能和肠功能的影响

Enteral nutrition treatment impact on immune function and intestine function recovery for the patients with gastric carcinoma

目的:探讨肠内营养与肠外营养对胃恶性肿瘤患者术后免疫功能与肠功能的影响。方法:对80例确诊并实施胃恶性肿瘤手术患者随机分为免疫增强型肠内营养干预组(Ⅰ组30例给予免疫增强型肠内营养混悬液)、常规肠内营养干预组(Ⅱ组20例,给予常规肠内营养混悬液)、肠外营养干预组(Ⅲ组30例)。术前1天及术后1天、3天、7天抽取静脉血,检测NK细胞活性和T淋巴细胞亚群(CD3^+、CD4^+、CD8^+)、IgG、IgM、IgA各项指标。记录并比较反映三组患者术后肠功能恢复情况的排气、进食、排便时间差异。结果:Ⅰ组、Ⅱ组患者术后经持续肠内营养支持治疗术后7天NK细胞活性较术前1天均上升,P<0.05,且Ⅰ组NK细胞活性明显高于Ⅱ组,P<0.05。术后3天及术后7天Ⅰ组、Ⅱ组、Ⅲ组患者CD3^+、CD4^+、CD8^+、IgG、IgM、IgA各项指标均存在显著性差异,P<0.05。Ⅰ组术后各项免疫指标明显高于Ⅱ组、Ⅲ组,其肠功能恢复时间较后两者明显缩短,并发症发生概率明显减少。结论:肠内营养干预可以显著提高胃恶性肿瘤患者的机体免疫功能,提高患者的生命质量,免疫增强型肠内营养效果更好。

Objective：To analyze enteral nutrition intervention and parenteral nutrition intervention impact on im-mune function and intestine function recovery for the patients with gastric carcinoma.Methods：All 80 patients with gastrointestinal cancer were randomly divided into groupⅠ（immune -strengthened enteral nutrition group,30 cases）, groupⅡ（enteral nutrition intervention group,20 cases）and group Ⅲ（parenteral nutrition intervention group,30 ca-ses）.On the 1st day of preoperation and 1st,3rd,7th day of postoperation,venous blood was extracted,and NK cell activity,T lymphocyte subsets （CD3 ＋,CD4 ＋,CD8 ＋）and the serum levels of IgA,IgG,IgMwere detected compared with the postoperative recovery.Results：Compared with the group Ⅱand Ⅲ,the NK cell activity,IgG,IgA,IgM, CD3 ＋,CD4 ＋,CD8 ＋ levels of group Ⅰon postoperative day 7 were higher,P〈0.05.Intestine function recovery time of groupⅠwas best and postoperative complication was least.Conclusion：Application of immune enhancing diets after gastric carcinoma surgery is safe and effective which can improve the patient＆#39;s immune function and prognosis.