全胃切除患者术后早期强化免疫营养的临床效果分析

Clinical efficacy of early enhanced enteral immune nutrition in patients after total gastrectomy

目的观察术后早期强化肠内免疫营养对全胃切除术患者的临床效果。方法全胃切除术后胃癌患者120例,所有患者均曾合并术前营养不良,其中60例患者术后早期接受普通肠内营养(EN组),另外60例接受强化的肠内免疫营养(EIN组)。分别于术前1天、术后第1天、术后第8天检测两组患者的营养指标(血清白蛋白、前白蛋白和转铁蛋白)及免疫指标(血清IgA、IgG、IgM和外周血T淋巴细胞亚群),并观察术后感染性的发生率。结果术前两组问各营养指标比较无显著性差异(P>0.05);两组患者术后第1天的各项营养指标和免疫指标较术前均显著下降(P<0.05);两组患者术后第8天的营养指标和免疫指标较术后第1天均有改善,且EIN组患者的各项免疫指标均高于EN组(P<0.05),两组间营养指标比较无统计学差异(P>0.05);EIN组术后感染性的发生率较EN组低(P<0.05)。结论术后早期肠内免疫营养能更好地改善全胃切除术后患者的免疫状态,并降低术后感染性发生率。

Objective To observe the clinical efficacy of early enhanced enteral immune nutri- tion in gastric carcinoma patients after total gastrectomy. Methods A total of 120 gastric carcinoma pa- tients treated with total gastrectomy were retrospectively analyzed in this study. Sixty patients were admin- istered with enteral immune nutrition （EIN）, while the others received standard enteral nutrition （EN）. The nutrition index （serum albumin, prealbumin and transferrins） and immune index （ IgA. IgG and IgM in serum and subpopulations of T cells in peripheral blood） were measured on 1 day before operation, 1 and 8 days after operation, respectively. Infection-related complications after operation also were evalua- ted. Results There were no significant differences in each preoperative nutrition index between the EIN group and EN group （P 〉 0.05 ）. After 7 days nutrition support, nutrition index and immune index were both improved in the two groups, and each immune index in the EIN group was higher than that in the EN group （P 〈 0.05 ）, but differences in nutrition index were not significant between the two groups （ P 〉 0.05 ）. The incidence of infection-related complications in the EIN group was lower than that in the EN group（P 〈 0.05）. Conclusion Early enteral immune nutrition can improve immune function and reduce the incidence of infection-related complications for patients treated with total gastrectomy.