术前肠内免疫营养对结肠癌病人免疫功能的影响

目的:探讨术前应用肠内免疫营养支持对结肠癌病人免疫功能的影响. 方法:将40例结肠癌病人随机分为两组,每组20例.试验组术前给予瑞能肠内免疫营养支持7 d,对照组术前常规饮食准备.观察术前和术后免疫指标以及术后感染性并发症的发生率及住院时间. 结果:术后两组病人各项免疫指标水平均有不同程度下降,但试验组手术前后各项指标无显著性差异;而对照组术后第3天的外周血淋巴细胞总数、CD4 /CD8 和术后第7 天的淋巴细胞总数、CD3 、CD4 、CD4 /CD8 、血清IgG、IgM水平均较入院时显著降低(P＜0.05);试验组术后第7天淋巴细胞总数、CD3 、CD4 、CD4 /CD8 和血清IgG、IgM水平明显高于对照组(P＜0.05);试验组术后感染性并发症的发生率显著低于对照组(P＜0.05);两组住院时间无显著性差异(P＞0.05). 结论:术前使用肠内免疫营养制剂,能明显改善结肠癌病人的免疫状况,减少术后感染性并发症的发生.

The effect of preoperative enteral immunonutrition on immune function in patients with colorectal cancer

Objective:To study the effect of preoperative immunonutrition on immune function in patients with colorectal cancer. Methods:Forty patients with colorectal cancer were randomized to receive either Supportan for 7 days before surgery(n=20)or a conventional diet(n=20).Immunological variables,postoperative infective complications,and the days of hospitalization were measured. Results:The postoperative immunological variables in both groups decreased unequally. But there were no significant differences in the immunological variables among different times perioperatively in study group.The counts of peripheral blood lymphocyte, CD3~ , CD4~ , CD4~ /CD8~ , IgG and IgM level on postoperative day 7 in study group were significantly higher than those in control group(P<0.05). The postoperative infective complication in study group was significantly lower than that in control group. There were no significant differences in the days of hospitalization between two groups. Conclusion:Preoperative enteral immunonutrition in patients with colorectal cancer can improve the immunity,and decrease the incidence of postoperative infective complications in patients with colorectal cancer.