免疫肠内营养支持对胃癌患者术后胃肠激素水平及免疫功能的影响

Effect of immune enteral nutrition support on postoperative gastrointestinal hormone levels and immune function in patients after gastric cancer operation

目的分析胃癌患者术后应用免疫肠内营养支持对其胃肠激素水平及免疫功能变化的影响。方法选取2017年3月至2019年3月在保定市第二医院实施手术治疗的胃癌患者95例,其中47例选择术后常规营养干预为对照组,48例予以免疫肠内营养干预为观察组。比较两组干预前后营养指标、胃肠激素水平及免疫功能指标的变化,比较两组术后恢复情况。结果干预后两组体重指数、肌酐-身高指数、氮平衡,以及血清转铁蛋白、清蛋白、前清蛋白、胃饥饿素、胃动素水平均升高,且观察组均明显高于对照组(P<0.05)。两组干预后血清免疫球蛋白G、A、M水平均高于干预前,且观察组均明显高于对照组(P<0.05)。干预后两组CD4^(+)细胞百分比及CD4^(+)/CD8^(+)比值均高于干预前,CD8^(+)细胞百分比低于干预前,且观察组CD4^(+)细胞百分比及CD4^(+)/CD8^(+)比值明显高于对照组,CD8^(+)细胞百分比明显低于对照组(P<0.05)。与对照组比较,观察组术后胃肠道恢复及住院时间更短(P<0.001)。结论免疫肠内营养支持的应用更利于恢复胃癌术后患者的营养状态,促进胃肠激素分泌和免疫功能的恢复,缩短胃肠道恢复时间。

Objective To analyze the effect of postoperative immune enteral nutrition support on gastrointestinal hormone levels and immune function in patients after gastric cancer operation.Methods Ninety-five patients with gastric cancer treated by surgery in Baoding Municipal Second Hospital from March 2017 to March 2019 were selected.Among them,47 cases received the postoperative routine nutrition intervention were served as the control group,and 48 cases received the immune enteral nutrition intervention were served as the observation group.The nutrition indexes,gastrointestinal hormone levels and immune function indexes before and after intervention were compared between the two groups,and the postoperative recovery situation was compared between the two groups.Results After intervention,the body mass index,creatinine-height index,nitrogen balance,serum transferrin,albumin,proalbumin,ghrelin and motilin levels in the two groups were increased,moreover the above indicators in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum immunoglobulin G,A,M after the intervention in the two groups were higher than those before the intervention,moreover the levels of above indicators in the observation group were significantly higher than those in the control group(P<0.05).After intervention,the proportion of CD4^(+)and CD4^(+)/CD8^(+)ratio in the two groups were higher than those before intervention,and the proportion of CD8^(+)was lower than that before intervention,moreover the proportion of CD4^(+)and CD4^(+)/CD8^(+)ratio in the observation group were significantly higher than those in the control group,and the proportion of CD8^(+)in the observation group was significantly lower than that in the control group(P<0.05).Compared with the control group,the gastrointestinal recovery and hospitalization time in the observation group were shorter(P<0.001).Conclusion The application of immune enteral nutritional support is conducive to restoring the nutritional status of patients after gastric cancer surgery,promoting gastrointestinal hormone secretion and immune function recovery,and shortening the gastrointestinal recovery time.