术前肠内免疫营养支持对食管癌辅助化疗患者营养状态及免疫功能的影响

Effect of preoperative enteral immunonutrition support on nutritional status and immune function of patients with adjuvant chemotherapy of esophageal cancer

目的探讨术前肠内免疫营养支持对食管癌辅助化疗患者营养状态及免疫功能的影响。方法选取我院100例术前均行新辅助化疗2个周期,并于新辅助化疗结束后3~4周行食管癌根治术的患者作为研究对象,按照随机数字表法分为对照组和观察组,对照组(n=50)化疗结束后给予常规饮食,观察组(n=50)增加口服肠内免疫营养,直至术前1 d。对比两组患者新辅助化疗第2疗程结束后1周、术前1 d、术后1 d、术后1周的营养及免疫指标。观察2组患者术后1 d下床活动时间完成例数、术后首次肛门排气时间、术后肠内营养相关不良反应发生例数、术后肺炎发生例数。结果观察组白蛋白、转铁蛋白、CD4^+、CD4^+/CD8^+在术前1 d、术后1 d、术后1周高于对照组(F=23.813 vs F=20.735、F=24.564 vs F=20.781、F=23.813 vs F=20.735、F=36.941 vs F=33.864、F=181.367 vs F=175.823),术后1d下床活动时间完成例数高于对照组(χ^2=10.741,P<0.05),术后首次肛门排气时间短于对照组(t=5.624,P<0.05),术后肠内营养不良、肺炎发生例数低于对照组(χ^2=4.762,P=0.029;χ^2=5.983,P=0.014)。结论术前肠内免疫营养支持应用于食管癌辅助化疗患者中通过改善患者营养及免疫指标、促进患者早期下床活动,缩短患者首次肛门排气时间,从而有效降低患者术后不良反应及肺炎的发生。

Objective To investigate the effect of preoperative enteral immune nutritional support on nutritional status and immune function in patients with esophageal cancer treated with chemotherapy.Methods 100 patients with esophageal cancer treated with preoperative neoadjuvant chemotherapy in 2 cycles and operated at 3~4 weeks after neoadjuvant chemotherapy in our hospital were selected as the research object.According to random number table method,all the patients were divided into observe group and control group,each with 50 cases.The control group were given regular diet after chemotherapy,and the observe group were given oral intestinal immune nutrition until 1 preoperative day.The nutritional and immune indexes of the two groups were compared at 1 week after the end of the second course of neoadjuvant chemotherapy,and also were compared at 1 day before,1 day after and 1 week after the operation.The number of cases of postoperative ambulation time,postoperative first anal exhaust time,postoperative enteral nutrition-related adverse reactions and postoperative pneumonia in the 2 groups were observed.Results The levels of albumin,transferrin,CD4^+,CD4^+/CD8^+ in the observation group were higher than those in the control group at 1 day before,1 day after and 1 week after surgery(F=23.813 vs F=20.735,F=24.564 vs F=20.781,F=23.813 vs F=20.735,F=36.941 vs F=33.864,F=181.367 vs F=175.823).Postoperative 1 d bed activity time to complete the number of cases was higher than that in the control group(χ^2=10.741,P<0.05).Postoperative anal exhaust for the first time was shorter than that the control group(t=5.624,P<0.05).Postoperative enteral nutrition,pneumonia cases were lower than those the control group(χ^2=4.762,P=0.029;χ2=5.983,P=0.014).Conclusion Preoperative enteral immune nutrition support is applied in patients with esophageal cancer assisted chemotherapy by improving nutrition and immune indicators,promoting patients'early ambulation and shortening the time of first anal exhaust,thus effectively reducing postoperative adverse reactions and the occurrence of pneumonia.