食管癌术后24h内与24h后肠内营养对患者营养状况、肠黏膜屏障和免疫功能的影响

Effect of enteral nutrition within 24 hours and 24 hours after esophageal carcinoma resection on nutrition status, intestinal mucosal barrier and immune function of patients

目的研究食管癌术后24 h内肠内营养与24 h后肠内营养对患者营养状况、肠黏膜屏障及免疫功能的影响。方法选择2015年4月~2016年7月南京军区福州总医院收治的60例食管癌患者,采用随机数字表法分为两组：术后24 h内给予肠内营养支持的A组和术后24~72 h内给予肠内营养支持的B组。评估两组患者的营养状况、免疫功能。结果肠内营养干预结束当天,A组患者血清中白蛋白（Alb）、前白蛋白（PA）、转铁蛋白（TF）、免疫球蛋白A（Ig A）、Ig G、Ig M、补体C3、补体C4的含量以及外周血中CD3＋T细胞、CD4＋T细胞、CD8＋T细胞、CD16＋CD56＋NK细胞的含量均显著高于B组;术后首次排便时,A组患者粪便组织中乳酸杆菌、双歧杆菌的含量显著高于B组,大肠埃希菌、肠球菌、变形杆菌的含量显著低于B组,差异均有统计学意义（P〈0.05）。结论食管癌术后24 h内肠内营养对术后营养状态、肠黏膜屏障功能以及免疫功能的改善作用优于术后24~72 h肠内营养。

Objective To study the effect of enteral nutrition within 24 hours and 24 hours after esophageal carcinoma resection on nutrition status, intestinal mucosal barrier and immune function of patients. Methods From April 2015 to July 2016, 60 cases of esophageal cancer patients in the Fuzhou General Hospital of Nanjing Military Command were selected and divided into two groups according to random number table method. Group A was given enteral nutrition within 24 hours after surgery and group B was received enteral nutrition 24 hours after surgery. The nutrition status and immune function of patients in the two groups were determined. Results In the end of enteral nutrition intervention,contents of serum Alb, PA, TF, Ig A, Ig G, Ig M, complement C3, complement C4 and CD3＋T, CD4＋T, CD8＋T, CD16＋CD56＋NK cell in peripheral blood of group A were significantly higher than those in the group B; after the first defecation, Lactic acid bacteria, Bacillus in feces tissues of the group A were significantly higher than those in the group B;Escherichia coli, Enterococcus, Strain Bacillus were significantly lower than those in the group B, the differences were statistically significant（P〈0.05）. Conclusion Improvement effect of enteral nutrition within 24 hours after esophageal carcinoma resection on nutritional status, intestinal mucosal barrier function and immune function is better than those of enteral nutrition 24 hours after surgery.