术后早期肠外营养对胃肠癌病人营养及免疫状况的影响

The Effect of Early Parenteral Nutrition Support After Operative on the Nutrition and Immunity Status of Patients with Gastroenteric Cancer

目的 探讨胃肠癌术后早期肠外营养支持的临床意义。方法 4 3例胃肠癌病人术后随机分为两组 :营养组 (n =2 2 )术后 1d开始静脉营养支持 ,持续 7d ,对照组 (n =2 1)术后常规补液 ;观察病人术前及术后 7d血浆白蛋白水平、PNI值、外周血淋巴细胞总数及T淋巴细胞亚群的变化。结果 营养组术后机体血浆白蛋白水平、PNI值与术前相比均无明显差异 (P >0 .0 5 ) ,而对照组术后血浆白蛋白水平、PNI值较术前明显下降 (P <0 .0 5 ) ;且营养组术后细胞免疫功能明显改善 (P <0 .0 5 ) ,其CD4+ /CD8+ 比值与对照组相比明显升高 (P <0 .0 5 )。结论 术后早期肠外营养支持能维持病人术后营养状况 ,改善机体免疫功能 。

Objective To observe the role of early parenteral nutrition support after surgery in patients with gastroenteric cancer.Methods Forty-three patients with gastroenteric cancer were divided into two groups randomly: the nutrition support group(n=22) receiving parenteral nutrition suppor for 7 days, and the control group(n=21) given general infusion support.The levels of plasma albumin(ALB),prognostic nutrition index(PNI),total lymphocyte count(TLC),T cell subgroup(CD 3 +CD 4 +CD 8 +)and CD 4 +/CD 8 + ratio were detected in the two groups before and after surgery.Results There was no significant difference of levels of ALB and PNI in the nutrition support group between before and after operation. In contrast,those in the control group were decreased after operation as compared with before operation(P<0.05).The cellular immune function of the nutrition support group was significantly improved after surgery(P< 0.05 ),while CD 4 +/CD 8 + ratio of the control group after operation was significantly lower than that of the nutrition support group.Conclusion The early parenteral nutrition support after operation could improve the nutrition and immune status of patient with gastroentric cancer.