食管癌术后早期肠内营养对胃肠及免疫功能恢复的影响

Effect of early enteral nutrition on gastrointestinal function and immune function in patients after esophagectomy

目的探讨食管癌术后早期肠内营养治疗对胃肠功能及免疫功能恢复的影响。方法选取2014年1月-2015年12月在解放军总医院胸外科接受手术的87例术后行早期肠内营养(enteral nutrition,EN)治疗的食管癌患者与同期87例接受肠外营养(paraenteral nutrition,PN)的食管癌患者,对两组的营养状态、胃肠功能及免疫功能进行比较。结果术后EN组排气、排便时间早于PN组[(68.5±19.7)h vs(76.8±22.5)h,P<0.05];[(4.27±1.5)d vs(4.98±2.2)d,P<0.05];术后1周EN组营养状态显著优于PN组[血清白蛋白(36.4±5.2)g/L vs(33.8±5.8)g/L,P<0.05],细胞免疫功能恢复程度优于PN组。结论早期肠内营养有利于促进术后胃肠功能恢复、改善患者营养状态和免疫功能。

Objective To evaluate effects of early enteral nutrition（EN） on gastrointestinal function and immune function in patients after esophagectomy. Methods Eighty-seven patients who underwent early enteral nutrition after esophagectomy in our hospital from January 2014 to December 2015 were enrolled in this study. The nutritional status, gastrointestinal function and immune function were observed and compared with those of 87 matched cases who underwent paraenteral nutrition（PN） and hospitalized in the same period. Results Postoperative time to first flatus and time to first defecation of patients in EN group were significantly shorter than those of PN group [（68.5±19.7） h vs（76.8±22.5） h, P〈0.05;（4.27±1.5） d vs（4.98±2.2） d, P〈0.05]. The level of nutrition indicators in EN group was higher than that in PN group at day 7 after operation [（36.4±5.2） g/L vs（33.8±5.8） g/L,P〈0.05].Recovery of cellar immune function in EN group was better than PN group. Conclusion Postoperative EN can promote the recovery of gastrointestinal function, improve nutritional status and enhance immune function, which is a preferred method of nutritional support treatment after esophagectomy.