早期肠内营养对直肠癌手术患者炎症因子及淋巴细胞的影响

Effects of early enteral nutrition on inflammatory factors and lymphocytes in patients with rectal cancer

目的观察早期肠内营养对直肠癌手术患者炎症因子及淋巴细胞的影响。方法 80例直肠癌术后患者随机分为两组,每组40例,对照组术后给予静脉营养,观察组术后给予早期肠内营养,分别在术前30 min和术后3、4、7 d采集患者外周血,采用ELISA法测定TNF-a、IL-6水平,采用流式细胞仪测定CD4^+T及CD8^+T细胞水平,比较两组检测结果。结果在术后3、4、7 d,观察组TNF-α和IL-6水平显著低于对照组(均P<0.05),而CD4^+T和CD8^+T细胞水平显著高于对照组(均P<0.05)。观察组术后出现腹胀4例,均经对症治愈,无患者因腹胀而中断肠内营养;对照组术后发生腹胀5例,两组不良反应发生率无统计学差异(P>0.05)。结论早期肠内营养有助于降低直肠癌手术患者TNF-α和IL-6水平,对调节机体炎性反应具有重要作用;且可使CD4^+T、CD8^+T细胞水平升高,有助于免疫功能恢复,具有重要临床价值。

Objective To observe the effects of early enteral nutrition on inflammatory factors and lymphocytes in patients with rectal cancer. Methods A total of 80 patients with rectal cancer were selected and randomly divided into two groups （n =40, respectively）. The control group was given parenteral nutrition while the observation group was given early enteral nutrition. Peripheral blood of patients was taken 30 minutes before the operation and three, four and seven days after the operation. ELISA method was taken to detect the levels of TNF-α and IL-6 levels and the levels of CD4＋T and CD8＋T cells were detected by flow cytometry. The detection results in the two groups were compared. Results Three, four and seven days after the operation, the levels of TNF-α and IL-6 in the observation group were significantly lower than those in the control group （P 〈 0.05）, while the levels of CD4＋T and CD8＋T cells were much higher than those in the control group （P 〈 0.05）. There were four cases of abdominal distension later cured by treatment in the observation group after the treatment; the enteral nutrition was not interrupted in any patient due to abdominal distension. There were five cases of abdominal distension in the control group after the treatment. There was no statistical difference in the incidence of adverse reactions in the two groups （P 〉 0.05）. Conclusion Early enteral nutrition can help reduce the levels of TNF-α and IL-6 of patients in rectal cancer surgery, which is important for the adjustment of inflammatory response of the body; it can improve the levels of CD4＋T and CD8＋Tcells, help the recovery of the inflammatory reaction and has great clinical significance.