胃癌患者围手术早期应用免疫增强型肠内营养制剂的临床观察

Clinical Observation of Early Application of Immune Enhanced Enteral Nutrition in Patients with Gastric Cancer

目的探讨围手术早期应用免疫增强型肠内营养制剂对胃癌患者营养状况、炎性反应和免疫功能的影响。方法选择行胃癌切除术的患者78例作为研究对象。按照随机数字法将入选患者分为观察组和对照组各39例。观察组于术后第1~8 d使用免疫增强型肠内营养制剂瑞能(华瑞公司),对照组使用常规肠内营养制剂瑞素(华瑞公司)。结果治疗后,观察组患者PA和TRF水平观察组较对照组显著升高,差异有统计学意义(P<0.05);血清IgM、IgG和IgA水平观察组显著高于对照组,差异有统计学意义(P<0.05)。观察组患者CD3和CD4细胞比例较对照组均显著升高,差异有统计学意义(P<0.05);CD8细胞比例较对照组有所下降,但是差异无统计学意义(P>0.05)。观察组TNF-α和IL-6水平显著低于对照组,差异有统计学意义(P<0.05);两组患者IL-2水平比较无统计学意义。结论胃癌患者围手术早期应用免疫增强型肠内营养制剂能显著改善患者营养状况,降低术后炎性反应,提高患者免疫力,有利于患者术后的康复,值得临床推广使用。

Objective To investigate the effect of immune enhanced enteral nutrition on nutritional status ,inflammatory response and immune function in patients with gastric cancer during perioperative period .Methods 78 patients with gastric cancer resection were selected as the study subjects .The patients were divided into the observation group and the control group ac -cording to random number method .In the observation group ,the immune-enhanced enteral nutrition preparation was used at the 1st to 8th day after operation,while the control group was treated with conventional enteral nutrition preparation Ruisu （Huarui）. Results After treatment,the levels of PA and TRF in the observation group were significantly higher than those in the control group （P〈0.05）.The serum levels of IgM,IgG and IgA were significantly higher in the observation group than those in the con-trol group （P〈0.05）.The percentage of CD3 and CD4 cells in the observation group was significantly higher than that in the control group （P〈0.05）,but the difference was not significant （P〉0.05）.The levels of TNF-αand IL-6 in the observation group were significantly lower than those in the control group （P〈0.05）.There was no significant difference between the 2 groups.Conclusion For gastric cancer patients during perioperation ,early application of immune enhanced enteral nutrition can significantly improve the nutritional status of the patients ,reduce the postoperative inflammatory reaction ,improve the immunity of patients,conducive to rehabilitation of patients after operation ,it is worthy of clinical application .