早期免疫强化肠内联合肠外营养支持对高龄胃癌胃切除术后患者营养状态及免疫功能的影响

Effect of early immune-enhanced enteral combined with parenteral nutrition support on nutritional status and immune function of elderly patients with gastric cancer after gastrectomy

目的:探究早期免疫强化肠内联合肠外营养支持对高龄胃癌胃切除术后患者疗效。方法:99选取我科2017年9月至2019年10月期间125例高龄胃癌行腹腔镜根治术后患者抽签法分组。对照组62例给予常规肠内营养支持,观察组63例给予早期免疫强化肠内联合肠外营养支持,对比两组营养状态、免疫功能、胃肠功能及并发症情况。结果:与术前3d相比两组前白蛋白(Prealbumin,PA)、白蛋白(Albumin,ALB)、转铁蛋白(Transferrin,TEN)、CD8+均降低,CD3+、CD4+、CD4+/CD8+均上升(P<0.05),其中观察组更为显著(P<0.05)。观察组术后首次排气时间、排便时间和进半流质饮食时间均低于对照组(P<0.05)。观察组术后并发症发生率略低于对照组,但无统计学意义(P>0.05)。结论:早期免疫强化肠内联合肠外营养支持对高龄胃癌胃切除术后患者治疗,可提升营养状态,改善免疫功能和胃肠功能,减低术后并发症。

Objective:To explore the effect of early immune-enhanced enteral combined with parenteral nutrition support on elderly patients with gastric cancer after gastrectomy.Methods:From September 2017 to October 2019,125 elderly patients with gastric cancer who underwent laparoscopic radical surgery were selected and divided into different groups.62 patients in the control group were given conventional enteral nutrition support,and 63 patients in the observation group were given early immune-enhanced enteral and parenteral nutrition support.The nutritional status,immune function,gastrointestinal function and complications of the two groups were compared.Results:Compared with 3rd day before surgery,after surgery with nutrition support the levels of Prealbumin(PA),albumin(ALB),transferrin(TEN)and number of CD8+were decreased in both groups,while numbers of CD3+,CD4+and CD4+/CD8+were increased(P<0.05).The alternations of these indexes in observation group were more significant(P<0.05).The first postoperative exhaust time,defecation time and half-liquid diet time in observation group were lower than those in control group(P<0.05).The incidence of postoperative complications in the observation group was slightly lower than that in the control group,with no statistical significance(P>0.05).Conclusion:Early immune-enhanced enteral combined with parenteral nutrition support can improve nutritional status,immune function and gastrointestinal function,and reduce postoperative complications for elderly patients with gastric cancer after gastrectomy.