全胃切除病人术后免疫增强型肠内营养的作用

目的:研究全胃切除病人术后早期免疫增强型肠内营养支持对机体免疫功能的影响.方法:选择进展期胃癌根治性全胃切除病人52例,随机分为免疫增强型肠内营养组(试验组)和常规肠内营养组(EN组).两组病人均从术后第1天起自营养管给予等热量、等氮量的肠内营养制剂.试验组使用免疫增强型肠内营养制剂Stresson,EN组使用常规的肠内营养制剂能全力,共7d.于术前及术后第1、8天分别抽取外周血,测定IgG、IgA、IgM及 T淋巴细胞亚群(CD3、CD4、CD8、CD4/CD8比值).结果:术后第1天,两组病人的各项免疫指标均有所下降,而术后第8天两组的IgG、IgM、IgA、CD3、CD4和CD4/CD8均明显回升,并高于术前水平,两组比较差异有显著性意义(P＜0.05).结论:胃癌根治性全胃切除病人术后早期免疫增强型肠内营养支持,可有效地改善病人的免疫功能.

The effect of postoperative immune-enhanced enteral nutrition on immune function in patients with total gastrectomy

Objective: To elucidate the effect of postoperative immune-enhanced enteral nutrition support on immune function in patients with total gastrectomy.Methods: Fifty-two gastric cancer patients with tatal gastrectomy were randomly divided into two groups: enteral nutrition group(EN group,n=26) and immune-enhanced enteral nutrition group(experiment group,n=26).The same quantity of calorie and nitrogen was provided from the first day after surgery for both groups.Patients in EN group received conventional enteral nutrition support with Nutrison,and patients in experiment group received immune-enhanced enteral nutrition support with Stresson for 7 days.The levels of IgG,IgA,IgM,CD3,CD4,CD8,CD4/CD8 were measured preoperatively and on day 1 and 8 after operation.Results: All the levels of immune function were decreased on postoperative day 1 in two groups.The levels of IgG,IgA,IgM,CD3,CD4 and CD4/CD8 were increased in both groups on postoperative day 8,and there was significant difference between two group(P<0.05). Conclusion: Early postoperative immune-enhanced enteral nutrition support could improve the immune function of gastric cancer patients with total gastrectomy,it works better than conventional enteral nutrition.