早期肠内营养对腹部严重创伤病人术后细胞免疫功能的影响

目的:研究术后早期肠内营养对腹部严重创伤病人术后细胞免疫功能的影响。方法:将30例腹部严重创伤的病人随机分为两组,肠内营养(EN组)和肠外营养(PN组),PN组术后行TPN支持。EN组术后第1d起经鼻饲管输注能全力,量由500mL/d递增至1500mL/d。分别于术前及术后第8d测定外周血T淋巴细胞亚群(CD3+、CD4+、CD8+)和NK细胞活性等细胞免疫指标。结果:PN组术后CD3+、CD4+、CD8+水平和NK细胞活性稍下降;而EN组术后CD3+、CD4+、CD8+水平和NK细胞活性与术前相比无显著变化。结论:早期肠内营养对腹部严重创伤病人术后有明显的细胞免疫增强作用,其作用优于肠外营养。

Effect of Early Enteral Nutrition on Cellular Immunity of Postoperative Patients with Severe Abdominal Trauma

Objective: To evaluate the effect of early enteral nutrition on cellular immunity of patients following surgery for severe abdominal trauma. Methods: 30 patients with severe abdominal trauma were randomly divided into two groups: enteral nutrition group (EN group) and parental nutrition group (PN group). PN group was given total parental nutrition (TPN). In the EN group, since the first post-operative day neutrinos(r) was infused, the infused volume was increasingly added from 500mL/d to 1500mL/d. Cell immune indicators such as T-cell subgroup (CD_3~+、CD_4~+、CD_8~+) and NK cell activity were measured before operation and on the 8th post-operative day. Results: The levels of CD_3~+、CD_4~+、CD_8~+ and NK cell activity were decreased in PN group after operation; In EN group the levels of CD_3~+、CD_4~+、CD_8~+ and NK cell activity did not change significantly. Conclusion: Compared with the parenteral nutrition, enteral nutrition can improve obviously the cellular immunity function in patients undergoing surgery for severe abdominal trauma.