早期微生态肠内营养在胃癌术后的应用

目的研究微生态制剂强化的肠内营养在胃癌术后的早期应用。方法60例进展期胃癌病人，随机分为微生态肠内营养组和对照组，每组30例。微生态肠内营养组于手术后第1天开始应用能全力加双歧杆菌活菌制剂，共7d；对照组单用能全力。监测各组患者手术前1d及手术后7d外周血内毒素、肿瘤坏死因子（TNF）水平变化及淋巴细胞计数改变，并观察粪便中分泌型IgA及菌群变化。结果术后7d微生态肠内营养组内毒素及肿瘤坏死因子水平明显低于对照组（P〈0．01），且淋巴细胞计数较术前显著增高（P〈0．05）；粪便中分泌型IgA微生态肠内营养组较对照组明显增高，差异有统计学意义（P〈0．05）；微生态肠内营养组患者肠道双歧杆菌、乳杆菌的总数明显增加（P〈0．05），肠道菌群接近正常比例，对照组仍存在一定程度菌群紊乱。结论胃癌术后早期应用微生态制剂强化的肠内营养可改善肠粘膜屏障功能及降低感染概率。

Enteral microecopharmaceutics nutrition in early postoperative patients with advanced gastric cancer

Objective To study the clinical effect of enteral microecopharmaceutics nutrition in early post-operative patients with advanced gastric cancer. Methods 60 patients with advanced gastric cancer were randomly divided into two group： enteral microecopharmacentics nutrition （ MEN - group, 30 cases）, regular enteral natrition group（EN- group, 30 cases）. Patients were infused with microecopharmaceutics Nutrison Fibre or Nutrison Fibre for 7 postoperative days. The concentrations of endotoxin, TNF and the number of lymphocyte in peripheral blood were analyzed. The changes of S - IgA and microflora in stool were studied. Results The levels of endotoxin and TNF in the MEN group were significantly lower than those in the EN group（ P 〈0.01 ） on 7th day after treatment. The number of lymphocyte in serum was significantly increased after operation in the MEN group while it has no significant alternation in the EN group（ P 〈 0.05 ）. The amount of S -IgA in stool was markedly increased in the MEN group than that in the EN group（ P 〈 0.05 ）. Bacterial culture revealed that the amount of bifidobaterium and lactobacilli were notably increased while E. coll. decreased in the MEN group（ P 〈 0.05 ）. Conclusion The enteral microecopharmaceutics nutrition showed the protective effects on gut harrier function and decreased the pestoperation infection rate of patients with advanced gastric cancer.