Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.

Microsurgical efficacy in 326 children with tethered cord syndrome: a retrospective analysis

Tethered cord syndrome is a progressive disease with a typically insidious onset in infants and children, and which can lead to persistent progress of neurological deficits and a high rate of disability without timely intervention. The purpose of this study was to investigate the curative effect of microsurgery in children with different types of tethered cord syndrome. In this study, we analyzed 326 patients with tethered cord syndrome, aged from 2 months to 14 years old, who were followed for 3–36 months after microscopic surgery. Based on clinical manifestations and imaging findings, these patients were classified into five types: tight filum terminale(53 cases), lipomyelomeningocele(55 cases), lipomatous malformation(124 cases), postoperative adhesions(56 cases), and split cord malformation(38 cases). All patients underwent microsurgery. Curative effects were measured before and 3 months after surgery by Spina Bifida Neurological Scale based on sensory and motor functions, reflexes, and bladder and bowel function. The results showed that Spina Bifida Neurological Scale scores improved in all five types after surgery. Overall effective rates in these patients were 75%. Effective rates were 91% in tight filum terminale, 84% in lipomyelomeningocele, 65% in lipomatous malformation, 75% in postoperative adhesion, and 79% in split cord malformation. Binary logistic regression analysis revealed that types of tethered cord syndrome(lipoma-type or not) and symptom duration before surgery were independent influencing factors of surgical outcome. These results show that therapeutic effect is markedly different in patients with different types of tethered cord syndrome. Suitable clinical classification for tethered cord syndrome will be helpful in predicting prognosis and guiding treatment.

达芬奇机器人与腹腔镜手术在中低位直肠癌中的近期疗效对比分析

目的对比分析达芬奇机器人与腹腔镜中低位直肠癌根治术的近期疗效,探讨达芬奇机器人手术的临床应用价值。方法分析2020年8月至2022年3月期间徐州医科大学附属医院行达芬奇机器人及腹腔镜中低位直肠癌根治术的病例,收集25例手术以后的达芬奇机器人病例数据,观察比较2组患者一般基线指标、手术相关指标及术后相关指标。结果48例患者接受达芬奇机器人手术,43例患者接受腹腔镜直肠癌手术,2组患者术后首次排气时间、术后尿管拔出时间、住院费用、术后疼痛分级、术后排尿功能障碍、术后排尿功能、性功能恢复差异具有统计学意义(P<0.05)。结论达芬奇机器人手术较腹腔镜手术在中低位直肠癌手术中的近期疗效更好,具有临床应用价值。

关于外翻手术治疗对策的讨论

[目的]分析不同手术方法治疗不同类型外翻的疗效。[方法]自2003年4月～2006年4月本院手术治疗外翻165例(210足)。根据外翻畸形程度不同分为3组。A组:共96例(128足),男21例,女75例;年龄20～65岁,平均42.5岁。外翻角(hallux valgus angle,HVA)25°～35°,平均30°,第1、2跖骨夹角(inter-metatarsalangle,IMA)12°～16°,平均14°。手术方法采用McBride加第1跖骨基底楔形截骨术。B组:共55例(61足),男11例,女34例;年龄38～62岁,平均50岁。HVA28°～44°,平均36°,IMA14°～18°,平均16°。手术方法与A组相同,另加第2跖趾关节成形术。C组:共15例(21足),男10例,女5例;年龄64～82岁,平均73岁。HVA45°～75°,平均60°,IMA18°～20°,平均19°。手术方法采用Kell手术。[结果]参照美国足踝外科学会Mary-land评分系统。随访6～24个月,平均15个月。A组,优98足,良24足,可6足,优良率95.3%。平均HVA矫正18°,平均IMA矫正7°。B组,优46足,良12足,可3足,优良率95.1%。平均HVA矫正21°,平均IMA矫正8°。C组,优11足,良8足,可3足,优良率90.5%。平均HVA矫正42°,IMA无矫正。[结论]外翻的病理基础主要为第1跖骨内翻的骨性畸形与收肌高度紧张挛缩的软组织畸形。手术应针对有明显临床症状的病人。手术的设计应重点解除骨性与软组织的畸形。只要注意手术操作与手术方法,手术并发证是可以避免的。

Recent Advances in Technique and Clinical Outcomes of Minimally Invasive Spine Surgery in Adult Scoliosis

Objective： Conventional open spinal surgery of adult scoliosis can be performed from anterior, posterior, or combined approach. Minimally invasive spine surgery （MISS） was developed for the purpose of reducing the undesirable effects and complications. This review aimed to make a brief summary of recent studies of the approach and clinical outcomes of MISS in adult scoliosis. Data Sources： We conducted a systematic search from PubMed, Medline, EMBASE, and other literature databases to collect reports of surgical methods and clinical outcomes of MISS in treatment of adult scoliosis. Those reports were published up to March 2017 with the following key terms： ＆quot;minimally invasive,＆quot; ＆quot;spine,＆quot; ＆quot;surgery,＆quot; and ＆quot;scoliosis.＆quot;Study Selection： The inclusion criteria of the articles were as followings： diagnosed with adult degenerative scoliosis （DS） or adult idiopathic scoliosis; underwent MISS or open surgery; with follow-up data. The articles involving patients with congenital scoliosis or unknown type were excluded and those without any follow-up data were also excluded from the study. The initial search yielded 233 articles. After title and abstract extraction, 29 English articles were selected for full-text review. Of those, 20 studies with 831 patients diagnosed with adult DS or adult idiopathic scoliosis were reviewed. Seventeen were retrospective studies, and three were prospective studies. Results： The surgical technique reported in these articles was direct or extreme lateral interbody fusion, axial lumbar interbody fusion, and transforaminal lumbar interbody fusion. Among the clinical outcomes of these studies, the operated levels was 3–7, operative time was 2.3–8.5 h. Both the Cobb angle of coronal major curve and evaluation of Oswestry Disability Index and Visual Analog Scale decreased after surgery. There were 323 complications reported in the 831 （38.9%） patients, including 150 （18.1%） motor or sensory deficits, and 111 （13.4%） implant-related complications. Conclusions： MISS can provide good radiological and self-evaluation improvement in treatment of adult scoliosis. More prospective studies will be needed before it is widely used.

麦默通微创旋切系统在乳房肿块切除中的应用:附7079例乳房病灶手术病理结果

目的探讨超声引导下麦默通微创旋切系统在乳房肿块切除术中的临床应用价值及其术后病理结果分析。方法回顾性分析5 135例行超声引导下麦默通微创旋切手术的乳房肿块患者术后并发症和病理检查结果。结果所有病灶中,1 708个为双侧乳房肿块,手术切除病灶为7 079个。术后167例(3.3%)患者发生并发症,包括术中出血22例、术后局部血肿131例、皮肤凹陷9例、肿瘤残留3例和皮肤损伤2例。术后乳房肿块病理检查结果示纤维腺瘤6 064个(85.9%)、乳腺腺病747个(10.6%)、导管内乳头状瘤96个(1.4%)、乳腺囊肿104个(1.5%)、导管上皮不典型增生29个(0.4%)、乳腺癌39个(0.6%)。39例乳腺癌微创切除术后,29例(74.4%)行保乳手术,术后病理分期0期12例,Ⅰ期25例,Ⅱ期2例。结论对于乳房肿块患者,乳腺麦默通微创旋切系统可准确切除乳房病灶,早期诊断乳腺癌,术后并发症发生率低。

微创食管癌术后淋巴结转移情况对预后的影响研究

目的探讨食管癌患者胸、腹腔淋巴结的转移规律及其对生存预后的影响。方法选取经微创食管癌切除术(minimally invasive esophagectomy,MIE)治疗的食管鳞癌患者103例,按照日本食管肿瘤研究会(Japan Esophageal Cancer Research Association,JEOG)淋巴结分区的标准进行淋巴结清扫,统计淋巴结的转移情况,分析淋巴结转移情况对3年总生存率的影响。结果胸上段食管癌主要向左、右喉返神经旁淋巴结转移。胸中段食管癌呈现双向淋巴结转移。胸下段食管癌主要向胃左动脉旁和肝总动脉旁淋巴结转移。食管癌患者3年总生存率在病变长度、分化程度、浸润深度、肿瘤位置和淋巴结转移方面比较,差异均具有统计学意义(均P<0.05)。结论淋巴结转移是影响胸段食管癌患者术后效果的重要影响因素,结合病变位置情况,重点清扫相应部位的淋巴结,并可依据病变长度、分化程度、浸润深度、肿瘤位置及淋巴结转移判定远期预后。

注射用血凝酶在腹腔镜胃癌根治术中止血作用的临床研究

目的探讨注射用血凝酶(巴曲亭)在腹腔镜胃癌根治术中和术后止血效果及对凝血功能的影响。方法选取行腹腔镜手术治疗的28例胃癌患者,随机分为血凝酶组和对照组。观察两组创面止血时间、术中出血量、术后3天创面出血渗血量及对患者凝血功能的影响。结果血凝酶组患者创面止血时间、术中出血量、术后3天创面出血及渗血量均明显少于对照组(均P﹤0.05);两组术前和术后凝血功能差异无统计学意义(P>0.05)。结论血凝酶在腹腔镜胃癌手术术中及术后具有良好的止血效果,对患者凝血功能无影响,临床应用安全有效。

新生儿坏死性小肠结肠炎致结肠穿孔手术方式探讨

目的通过对新生儿坏死性小肠结肠炎致结肠坏死穿孔的患儿进行回顾性分析,探讨最佳手术方式。方法选取2018年5月1日至2020年5月1日该院新生儿坏死性小肠结肠炎致结肠坏死穿孔的患儿47例作为研究对象,将其分为坏死结肠切除组(对照组,n=21)及坏死结肠修补组(观察组,n=26),利用SPSS20.0统计软件对疗效及临床转归进行分析。结果观察组急诊手术时间明显短于对照组,而在炎症恢复时间及关瘘手术持续时间方面均长于对照组,差异均有统计学意义(P=0.04、0.04、<0.01);两组患儿在术后呼吸机使用时间、进食时间、术后肠外营养支持时间、住院时间及术后并发症等临床转归方面比较,差异均无统计学意义(P>0.05)。结论2种手术方式均可作为新生儿坏死性小肠结肠炎致结肠坏死穿孔的处理方式,而最佳手术方式的选择取决于新生儿手术时的状态。在新生儿基础条件差、血流动力学不稳定等情况下可选择结肠修补术,而在患儿生命体征稳定情况下可选择结肠坏死切除术。

臀肌松解术治疗臀肌挛缩症

目的 报道臀肌松解术治疗臀肌挛缩症的手术方法及治疗效果。方法 采用臀肌松解术治疗 6 4例臀肌挛缩症患儿 ,术中单纯切断加部分切除纤维挛缩组织 ,术后早期进行并膝屈髋功能锻炼 ,防止粘连。结果 本组术后获随访 5个月～ 10年 ,优良率 98%。无复发病例。结论 本术式治疗臀肌挛缩症有明显优点 :操作简单 ,创伤小 ,疗效可靠。

颅内破裂动脉瘤的手术方式与癫痫发作的关系

目的探讨颅内破裂动脉瘤患者的手术方式对癫痫发作的影响,以及与出血严重程度和患者预后的关系。方法回顾性分析我院神经外科2013年5月至2017年5月手术治疗的颅内破裂动脉瘤患者的临床资料,根据手术方式,患者被分为夹闭组和栓塞组,比较两组的基线特征,并发症和预后,并根据临床分级,比较癫痫发作率和患者预后<结果363例患者行开颅夹闭手术,211例患者行介入栓塞手术,两组的癫痫发作率无明显差异(P=1.000),但在Hunt-Hess1-3级和改良Fisher1-2级的患者中,夹闭组的患者癫痫发作率明显更高(P=0.036;P=0.013)。在Hunt-Hess1-3级和改良Fisher1-2级的患者中,有癫痫发作的比无癫痫发作的预后更差(P=0.010;P=0.031)。结论破裂动脉瘤患者在两种手术后癫痫发作率无明显差异,但在临床分级低的患者中,开颅夹闭手术后癫痫发作率更高,且与预后不良相关。

三种手术方式对腰椎间盘突出症临床疗效的影响

目的探讨三种手术方式对腰椎间盘突出症(LDH)临床疗效的影响。方法 2007年1月~2012年10月于我科行手术治疗LDH的患者中选择110例患者,男63例,女47例;年龄18~73岁,平均45岁;均为单节段椎间盘突出(L3/46例,L4/560例,L5/S144例)。分别采用腰椎间盘髓核摘除术(A组,40例)、椎间融合联合单侧椎弓根螺钉内固定(B组,51例)、腰椎间盘髓核摘除联合棘突间稳定装置X-STOP系统植入(C组,19例),3组患者一般资料比较差异均无统计学意义(>0.05)。每位患者术前及术后末次随访时通过完成欧洲五维健康量表及进行Oswestry功能障碍指数评分,比较评分改善情况。结果 110例患者均获得随访,平均随访时间18个月(6~38个月),末次随访时EQ-VAS评分、EQ-5D健康指数和ODI评分组内比较均明显改善(<0.05),组间比较均无统计学差异(>0.05)。结论对于单纯LDH可行腰椎间盘髓核摘除术,LDH合并腰椎不稳者可行椎间融合+单侧椎弓根螺钉内固定,对于椎间盘突出合并椎管狭窄,尤其是临床症状在屈曲位缓解的患者尤其适宜椎间盘髓核摘除联合棘突间动态内固定。

内、外侧联合双柱内固定治疗23例肩胛骨体部移位骨折患者疗效分析

目的:分析内、外侧微创切口双柱固定治疗肩胛骨体部移位骨折的临床疗效。方法:2014年1月至2018年6月采用内、外侧微创切口手术治疗肩胛骨体部移位骨折患者23例。外侧切口:沿肩胛骨外侧缘、外柱骨折线向上牵开三角肌后部,自小圆肌与冈下肌间隙显露出肩胛骨外缘。内侧切口:沿肩胛骨内侧缘、内柱骨折线顺斜方肌纤维分离,经菱形肌与冈下肌肩胛骨附丽点间隙分离进入,显露肩胛骨内侧缘。两柱均用钢板螺丝钉进行框架式内固定。结果:除1例患者的切口脂肪液化经二次处理后愈合,其余所有患者切口一期愈合。骨折肩胛骨盂极角术前为(25±12)°,术后为(41±5)°,差异有统计学意义(P<0.01)。骨折愈合时间为3~8个月,平均(4.4±1.3)个月。结论:采用内、外侧联合双柱内固定手术治疗肩胛骨体部移位骨折便于骨折显露、复位和可靠固定,且软组织剥离少,患者骨折愈合率高,功能恢复良好。

Adult metaplastic hutch diverticulum with robotic-assisted diverticulectomy and reconstruction:A case report

BACKGROUND Hutch diverticulum arises from the compromised muscular development at the ureteral orifice.It is a congenital disease and extremely rare in adult,only accounting for about 3%occurrence worldwide.It can be either symptomatic or asymptomatic,and relies on image tools for diagnosis and preoperative planning.Indications for surgery are dependent on the complications from the diverticulum.Metaplasia is about 10%among those with hutch diverticulum,and it still has chances turning into malignancy,especially urothelial cell carcinoma.CASE SUMMARY A 27-year-old man was presented with frequently recurrent urinary tract infection for one year,and had suffered from intermittent right flank pain for 3 mo.No past medical histories were recorded before.No obvious abnormalities on laboratory data and urine examination were found.Under ultrasound,right hydronephrosis was seen and an anatomical abnormality was observed on intravenous pyelography.Further computed tomography urogram showed one diverticulum seated at superolateral side of right ureteral orifice.Cystoscopy was done and biopsy results showed focal metaplasia.After discussing with him,roboticassisted diverticulectomy with reconstruction was performed.Right hydronephrosis was greatly improved after surgery.He has completed his 1.5-year follow-ups,and no malignancies were seen from urine cytology and image of intravenous pyelography.CONCLUSION Robotic-assisted diverticulectomy and reconstruction to hutch diverticulum is a safe and efficient operation,providing several advantages over open and laparoscopic ones.

复杂型先天性肠闭锁患儿治疗体会

目的:总结复杂型先天性肠闭锁的治疗经验,探讨其治疗要点及手术效果。方法:回顾性分析2012年1月至2018年1月山东大学齐鲁儿童医院收治的49例复杂型肠闭锁患儿的临床资料,收集患儿的年龄、性别、手术日龄、是否足月、出生体质量、临床表现、辅助检查、初步诊断、治疗过程、出院诊断、病理结果、预后等信息,并进行分析。结果:所有患儿均行手术治疗,其中传统开腹手术治疗42例(85.7%),腹腔镜手术治疗7例(14.3%,1例因合并胎粪性腹膜炎中转开腹手术)。所有患儿手术时间为70~270 min,平均(147±43)min;术后禁食时间为4~16 d,平均(8±3)d;肠外营养时间为3~30 d,平均(12±6)d。11例患儿术后自动出院并失访。其余38例患儿中,1例(2.6%)因消化道穿孔于术后第5天行肠切除吻合术;1例(2.6%)于术后1个月因粘连性肠梗阻再次入院并行保守治疗;1例(2.6%)于术后第8天因吻合口瘘行肠粘连松解和回肠造瘘术,3个月后行二期闭瘘术;4例患儿术后分别出现水、电解质紊乱,低蛋白血症,高胆红素血症等并发症,均保守治疗后好转。术后随访期间,1例十二指肠闭锁患儿术后6个月较同龄健康儿童体质量低2个标准差,至1岁时体质量达到同龄健康儿童水平;1例32周早产患儿术后行肠内营养治疗,6个月后逐渐恢复正常饮食;其他患儿均无明显生长发育迟缓。结论:复杂型肠闭锁患儿经积极治疗,术中尽可能保留正常肠管,预后大多良好。

胸腔镜下肺癌根治术淋巴结清扫的临床研究

目的探讨全胸腔镜下肺癌根治术淋巴结清扫的治疗效果。方法选择住院治疗的肺癌患者400例。按照治疗方法进行分组,行全胸腔镜下肺癌根治术患者250例,为治疗组;行常规开胸手术患者150例,为对照组。结果治疗组和对照组手术均顺利完成。两组的淋巴结清扫数及阳性淋巴结数基本相同。治疗组的术后引流时间、术后引流量、术后住院时间均较对照组低(均P<0.05)。结论全胸腔镜下肺癌根治术的淋巴结清扫对患者造成的创伤较小、术后恢复时间较短,对淋巴组织的清扫更加彻底,因此具有非常广阔的临床应用前景。

图片式体位解释法对手术室患者体位配合程度及并发症的影响

目的探讨图片式体位解释法对手术室患者体位配合程度及相关并发症的影响。方法选取医院2018年1—10月收治的外科手术患者180例为研究对象,按照患者性别、年龄、体重、科室来源、手术体位及文化程度组间均衡可比的原则,分为对照组和观察组,每组90例。对照组单纯以语言方式解释手术体位,观察组结合图片式体位解释法,比较两种不同的手术体位解释方式对患者体位配合程度、体位摆放时间、舒适度和手术体位相关并发症的影响。结果观察组患者摆放体位所需时间明显短于对照组,差异有统计学意义(P<0.05);观察组患者手术体位配合程度、体位舒适度明显高于对照组,差异有统计学意义(P<0.05);观察组手术体位相关并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论运用图片式体位解释法对手术患者进行手术体位指导和护理,可有效提高患者体位配合程度和舒适度,缩短体位摆放用时,减少手术体位相关并发症的发生率。

双环法整形保乳术在早期近乳晕区乳腺癌手术中的临床应用价值

目的评价双环法整形保乳术治疗近乳晕区早期乳腺癌的临床疗效。方法选取2019年3月—2023年10月海南医学院第一附属医院乳胸外科收治的符合研究标准的早期近乳晕区乳腺癌患者114例为研究对象,采用随机数字表法分为观察组和对照组,观察组57例实施双环法整形保乳术,对照组57例采用传统保乳整形手术,比较两组患者的切除标本量、切缘距离、围术期指标(术中出血量、手术时间及住院日)、乳房美学效果及并发症情况。结果观察组患者切除的乳腺标本量[(86.72±9.76)g]和肿瘤距外科切缘距离[(18.63±4.67)mm]均优于对照组切除的乳腺标本量[(53.67±5.36)g]和肿瘤距外科切缘距离[(13.42±1.37)mm],差异均有统计学意义(t=22.409、8.082,均P<0.05)。观察组患者的临床观察指标[术中出血量(30.52±6.38)ml、手术时间(88.58±12.16)min及住院时间(7.82±1.23)d]与对照组[术中出血量(28.62±6.57)ml、手术时间(85.76±7.99)min及住院时间(7.42±1.31)d]比较,差异均无统计学意义(t=1.566、1.463及1.681,均P>0.05)。在并发症方面(包括血肿形成、乳房疼痛、切口愈合不良及裂开),观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后2个月,观察组患者乳房美容评分[(29.36±2.87)分]和优良率(92.98%)均高于对照组乳房美容评分[(24.65±2.82)分]和优良率(70.17%),差异均有统计学意义(t=8.838,χ^(2)=9.864,均P<0.05)。结论近乳晕区早期乳腺癌采用双环法整形保乳术较传统保乳术具有更广的切除范围、更大的切除组织量,更低的并发症发生率,有效提升了乳房的美容效果。

宫颈机能不全的危险因素分析及不同手术方式对母婴结局的影响

目的分析宫颈机能不全的危险因素,探讨不同手术方式对母婴结局的影响。方法回顾性分析2018年7月—2021年6月赣州市妇幼保健院收治的128例宫颈机能不全孕妇的病历资料,为研究组。另选取同期正常妊娠孕妇140例为对照组。比较两组一般情况以及其他临床资料,采用多因素logistic回归分析明确宫颈机能不全的危险因素。将研究组孕妇按照手术方式分为预防性宫颈环扎组(74例)、治疗性宫颈环扎组(38例)以及紧急性宫颈环扎组(16例),比较3组母婴结局。结果研究组孕次、产次以及流产次数均高于对照组(均P<0.05)。研究组辅助生殖受孕、早产史、清宫术史、剖宫产史以及多囊卵巢综合征比例分别为34.38%、24.22%、52.34%、55.47%、6.25%,均高于对照组的6.43%、10.00%、12.86%、22.86%、0.71%,差异均有统计学意义(χ^(2)=26.916,9.676,48.140,30.054,6.341,均P<0.05)。多因素logistic回归分析发现:孕次≥2次、产次>1次、流产次数≥1次以及辅助生殖受孕、早产史、清宫术史、剖宫产史、多囊卵巢综合征均是宫颈机能不全的危险因素(均P<0.05)。结论孕次、产次、流产次数以及辅助生殖受孕、早产史、清宫术史、剖宫产史、多囊卵巢综合征均与宫颈机能不全有关。此外,预防性宫颈环扎以及治疗性宫颈环扎用于宫颈机能不全孕妇的母婴结局优于紧急性宫颈环扎治疗。

免疫增强型肠内营养对胃癌根治患者术后免疫功能和炎症反应的影响

为了观察术后免疫增强型肠内营养对胃癌根治患者术后免疫功能及炎症反应的影响，选择胃癌根治患者42例，采用简单随机分组法，即抽签法分为免疫增强型肠内营养组（研究组）和常规肠内营养组（对照组）各21例。两组患者均于术后d-～ds，研究组使用含谷氨酰胺、精氨酸、ω-3多不饱和脂肪酸的免疫增强型肠内营养制剂，对照组使用常规的制剂能全力。观察术前1d、术后1d和术后9d两组患者的免疫指标和炎症反应指标：1）T淋巴细胞亚群（CD3、CD4、CD8、CD4／CD8）、自然杀伤（NK）细胞、免疫球蛋白（IgG、IgM、IgA）；2）肿瘤坏死因子（TNF—α）、血清中细胞因子白介素（IL-6）。结果研究组术后第9天，CD3、CD4、CD8、CD4／CD8、NK和免疫球蛋白（IgG、IgM、IgA）明显高于对照组，P〈0．05；炎症反应指标，研究组IL-6、TNF—α显著低于对照组，P〈0．05。初步研究结果提示，免疫增强型肠内营养可减轻胃癌根治患者术后的机体炎症反应，改善免疫功能。