早期肠内营养对消化道恶性肿瘤术后免疫功能的影响

目的观察早期肠内营养对消化道恶性肿瘤术后免疫功能的影响。方法40例消化道恶性肿瘤病人随机分成两组,肠内营养组(enteralnutrition,EN组)与肠外营养组(parenteralnutrition,PN组),每组各20例。EN组术后24h以内管喂肠内营养液能全力,PN组给予等氮、等热卡的肠外营养,营养支持共7d。两组病人分别术前和术后第1、第8天测定C3、IgA、IgM、IgG和CD3 、CD4 、CD8 及CD4 /CD8 。并观察肠蠕动恢复时间及感染率的变化。结果7天后EN组补体C3、IgA、IgG、CD4 及CD4 /CD8 的恢复程度与PN组有显著性差异;EN组感染率(10.00%)较PN组低。结论消化道恶性肿瘤术后早期肠内营养有利于能改善免疫功能,促进肠蠕动恢复,降低病人术后感染率,是值得推广的营养支持方式。

Effect of early enteral nutrition on immunologic function for after operation of gastrointestinal malignant tumors

Objective To observe the effects of early enteral nutrition(EN)on immunologic function for after operation of gastrointestinal malignant tumors.Methods From March 2001 to March 2005,40 cases with gastro-intestinal malignant tumors were randomly divided into two groups,namely enteral nutrition group and parenteral nutrition group.Each group was 20 cases.C3,IgA,IgM,IgG and CD3 ,CD4 ,CD8 ,CD4 /CD8 of the two groups were detected on the day before the operation and the postoperative days 1st and 8th.And the restoring time of intestinal peristalsis and infective rate were observed.Results In postoperative 7th days,the changes of C3,IgA,IgG CD4 and CD4 /CD8 in EN group were significantly different from PN group(P<0.05).In the restoring time of postoperative intestinal peristalsis,the EN group was shorter than that PN group(P<0.05).Conclusions Early enteral nutrition may have beneficial effect on improving immunologic function,promoting the recovery of intestinal peristalsis and reducing postoperative infective rate.