肠内营养联合肠外营养对食管癌患者术后营养状况及免疫功能的影响

Effect of enteral nutrition combined with parenteral nutrition on nutritional status and immune function in patients with esophageal cancer after operation

目的研究肠内营养联合肠外营养对食管癌患者术后营养状况及免疫功能的影响。方法选取2015年1月至2016年12月在郑州大学第一附属医院胸外科接受胸腹腔镜联合食管癌根治性手术治疗的120例食管癌患者,按随机数表法将所有患者分为两组,对照组患者接受肠外营养支持治疗,观察组患者接受肠内营养联合肠外营养支持,比较两组患者治疗前后的营养状况指标[血清转铁蛋白(TRF)、白蛋白(ALB)、前白蛋白(PA)]及免疫功能指标[淋巴细胞计数(LYM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)及CD4^+/CD8^+]水平。结果治疗后,观察组血清TRF、ALB、PA水平均高于对照组,差异有统计学意义(P<0.05);观察组血清LYM、IgA、IgG、IgM、CD4^+/CD8^+水平均高于对照组,差异有统计学意义(P<0.05)。结论肠内外联合营养支持可有效改善食管癌患者术后的营养状况和免疫功能,值得推广应用。

Objective To investigate the effect of enteral nutrition combined with parenteral nutrition on nutritional status and immune function in patients with esophageal cancer after operation. Methods In this study, 120 patients with esophageal cancer treated with thoracoscopic - laparoscopic esophageal cancer radical surgery in the department of thoracic surgery of the First Affili- ated Hospital of Zhengzhou University from January of 2015 to December of 2016 were selected as the subjects. All subjects were randomly divided into two groups. The patients in control group accepted parentcral nutrition and the patients in observation group accepted enteral nutrition combined with parenteral nutrition support. Nutritional status and immune function of patients in two groups were compared. Results After treatment, the levels of TRF, ALB, PA in observation group were higher than control group, and the differences were statistically significant （ P 〈 0.05 ）. The levels of LYM ,IgA ,IgG ,IgM ,CD4＋/CD8＋ after treatment were higher than control group, and the differences were statistically significant （P 〈 0. 05）. Conclusion Enteral nutrition combined with parenteral nutrition can improve the postoperative nutritional status and immune function of patients with esophageal cancer, and is worthy of clinical application.