肠内外营养对胃癌根治性切除术患者免疫功能的影响

目的 比较肠内营养支持（enteral nutrition，EN）、肠外营养支持（parenteral nutrition，PN）对胃癌根治性切除术术后患者肠道功能恢复、住院时间和免疫功能的影响。方法 选取2011年1月至2014年5月在我院治疗的80例胃癌根治性切除术患者为研究对象，随机分为EN组和PN组各40例，比较两组患者术后肠道功能恢复的时间、住院时间及免疫功能的指标。结果 EN组患者术后肠道通气时间及平均住院时间均显著短于PN组（P均＜0.05）；EN组患者术后1 d及术后7d IgA、IgG、IgM、CD3⁺的水平及术后7 d CD4⁺的水平均显著高于PN组，差异有统计学意义（P均＜0.05）。两组患者术后1 d及术后 7 d的NK细胞、C反应蛋白（C-reactive protein，CRP）的水平及术后1 d CD4⁺的水平差异均无统计学意义（P均＞0.05）。结论 EN对促进胃癌根治性切除术患者肠道功能恢复及提高免疫功能均优于PN，且住院时间较短，值得临床推广应用。

Comparison of intestinal enteral and parenteral nutrition on immune function of patients undergoing radical gastrectomy

 Objective To compare the influence of enteral and parenteral nutrition（EN/PN） on intestinal function，postoperative hospitalization duration and immune state of patients undergoing radical gastrectomy. Methods A total of 80 patients who underwent radical gastrectomy from January 2011 to May 2014 were recruited as research subjects，and they were randomly divided into EN and PN groups. Intestinal function， postoperative hospitalization duration and immune state were measured in each group and compared. Results Intestinal ventilation time and postoperative hospitalization duration were significantly shorter for the EN group than for the PN group（P<0.05）. Levels of IgA，IgG，IgM，and CD3+ at 1 and 7 d after surgery were significantly higher in the EN group（P<0.05）， as was the level of CD4⁺ at 7 d after surgery. The two groups showed similar levels of NK cells and CRP at 1 and 7 d after surgery，as well as similar levels of CD4⁺ at 1 d after surgery （P>0.05）. Conclusion EN may be associated with greater recovery of intestinal and immune function after radical gastrectomy than PN.