应用肠内免疫营养与生态营养对胃癌术后患者营养支持疗效的前瞻?随机?对照临床研究

目的:探讨肠内免疫营养与生态营养对胃癌术后患者营养状态和免疫水平的影响.方法:将60例胃癌患者双盲、随机分为普通肠内营养组(enteral nutrition,EN组,15例)、普通肠内营养+生态营养组(enteral microeco-pharmaceutics nutrition,EMN 组,15例)、肠内免疫营养组(immue-enhancing enteral nutrients,EIN组,15例)、肠内免疫营养组+生态营养组(enteral micmecopharmaceutics immunonutrition,EMIN组,15例),比较4组患者的术后营养状况、免疫功能、氮平衡以及菌群失渊情况.结果:EIN组与EN组相比,EIN组能提高术后IgG、IgA水平,减少肠管内大肠杆菌、球杆菌含量,增高双歧杆菌、乳杆菌含量(P<0.05),EMN组与EN组相比,EMN组能提高术后IgG、IgA水平,减少肠管内大肠杆菌、球杆菌含量.增高双歧杆菌、乳杆菌含量(P<0.05),EMIN组与EN组相比,EMIN组能提高术后总蛋白、白蛋白、前白蛋白、IgG、IgA,IgM、CD3、CD4以及CD4/CD8水平,加速纠正负氮平衡,减少肠管内大肠杆菌、球杆菌含量,增高双歧杆菌、乳杆菌含昔(P<0.05),EMIN组与EMN组、EIN组相比,EMIN组术后总蛋白、白蛋白、前白蛋白、IgG、IgA,IgM、CD3、CD4以及CD4/CD8水平、氮平衡指数.肠管内双歧杆菌、乳杆菌含量明显高于EMN组、EIN组,肠管内大肠杆菌、球杆菌含量明显低于EMN组、EIN组(P<0.05).EN组、EIN组以及EMN组的术后总蛋白、白蛋白、前白蛋白、IgM、CD3、CD4、CD4/CD8水平以及净氮平衡指数差异无统计学意义(P>0.05).结论:胃癌术后,联合应用肠内免疫营养与生态营养对胃癌术后患者营养支持,与单独使用肠内免疫营养或者生态营养相比.能更好的促进患者蛋白质合成、免疫功能恢复、纠正负氮平衡以及肠道菌群失衡.

Effects of postoperative immue-enhancing enteral nutrients and probiotics on metabolic and immunologic status in patients undergoing radical gastrectomy surgery: a randomized, controlled trial

Objective:To explore the effect of immue-enhancing enteral nutrients together with enteral microeco-pharmaceutics nutrition in patients undergoing radical gastrectomy surgery. Methods:Sixty gastric cancer patients were randomly divided into EN group(n = 15), EMN group(n = 15), EIN group(n = 15), and EMIN group(n = 15). Nitrogen balance, nutritional status, immune function, exhaust time and intestinal flora status were compared among the 4 groups. Results:The level of IgG, IgA and the quantity of Bacillus bi...