术前营养支持对胃癌合并肌少症患者术后炎症反应及细胞免疫的影响

Effects of preoperative nutritional support on postoperative inflammatory response and cellular immunity in patients with gastric cancer complicated with sarcopenia

目的 探讨术前营养支持对胃癌合并肌少症患者术后炎症反应及细胞免疫的影响。方法 选取2021年1月—12月于本院行手术治疗的126例胃癌合并肌少症患者,实验组(63例)术前行营养支持,对照组(63例)术前未行常规营养支持。比较2组患者炎症反应、细胞免疫及术后恢复指标。结果 2组患者术后第1天、第3天、第5天各炎症指标、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞水平和对照组术后第1天CD4^(+)/CD8^(+)水平均高于同组入院时水平,差异有统计学意义(P<0.05)。实验组术后第1天、第3天、第5天各炎症指标、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞水平均低于对照组,差异有统计学意义(P<0.05)。实验组术后住院时间、术后并发症发生率和严重并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论 术前营养支持可以减轻胃癌合并肌少症患者术后炎症反应,改善术后免疫功能状态,促进术后恢复,值得临床推广。

Objective To explore the effects of preoperative nutritional support on postoperative inflammatory response and cellular immunity in patients with gastric cancer complicated with sarcopenia. Methods A total of 126 patients with gastric cancer complicated with sarcopenia who underwent surgery from Jan. 2021 to Dec. 2021 were selected. The experimental group(n=63) received preoperative nutritional support, while the control group(n=63) did not receive routine nutritional support before operation. Inflammatory response, cellular immunity and postoperative recovery were compared between the two groups. Results The inflammation indexes and the levels of CD3^(+)T cell, CD4^(+)T cell, CD8^(+)T cell on 1st, 3rd, 5thday after operation in both groups and CD4^(+)/CD8^(+)on 1stday on admission in control group were higher than the preoperative level in the same group(P<0.05). In the experimental group, the inflammation indexes and the levels of CD3^(+)T cell, CD4^(+)T cell, CD8^(+)T cell on 1st, 3rd, 5thday after operation were lower than those in the control group, with the differences statistically significant(P<0.05). The postoperative hospital stay, the incidence of postoperative complications and the incidence of severe complications in the experimental group were lower than those in the control group, with the differences statistically significant(P<0.05). Conclusion Preoperative nutritional support can reduce postoperative inflammatory response, improve postoperative immune function and promote postoperative recovery in patients with gastric cancer complicated with sarcopenia, which is worthy of clinical promotion.