早期肠内营养对老年胃癌根治术后预后及炎症反应的影响

目的：探讨早期肠内营养（EN）对老年胃癌患者术后营养状况、丙二醛（MDA）、超氧化物歧化酶（SOD）及机体炎症反应性的影响。方法：将80例胃癌根治术患者随机分为EN组及肠外营养（PN）组，各40例，EN组于术后第1天给予早期肠内营养支持治疗，PN组于术后第1天给予胃肠外营养支持治疗，对比分析两组患者术前、术后第1天、术后第7天营养指标IgG、氮平衡（NB）、总蛋白（TP）、血清蛋白（ALB）]、MDA、SOD及炎症因子白介素-2、6、8（IL-2、6、8）和肿瘤坏死因子-α（TNF-α）变化情况。结果：与术后1d相比，两组治疗术后7dIgG、NB、TP、ALB水平均显著改善（P〈0．05），而EN组术后7d各营养指标改善效果优于PN组，差异有统计学意义（P〈0．05）。两组患者术后第1天血清SOD水平显著下降，术后第7天恢复至术前水平，而EN组术后第7天MDA值恢复至术前水平，PN组MDA值高于EN组，差异有统计学意义（P〈0．05）。两组患者术后第1天IL-2、6、8和TNF-α水平显著升高，术后第7天两组IL-2、6、8和TNF-α水平低于术后第1天，且EN组低于PN组，差异有统计学意义（P〈0．05）。结论：早期肠内营养支持可有效改善机体营养，调节血清sOD、MDA变化，降低机体炎症应激性反应，促进机体康复。

Effect of early enteral nutrition on prognosis and inflammation reaction after radical resection in elderly patients with gastric cancer

Objective. To investigate the impact of early enteral nutrition （EN） on malondialdehyde （MDA）, superoxide dismutase （SOD）, nutrition condition and inflammatory response of elderly patients with gastric cancer. Methods. A total of 80 cases of gastric cancer patients were randomly divided into EN group （n=40） and parenteral nutrition group （PN） group （n=40）. EN group received EN support thera- py 1 d after surgery. PN group were given with PN therapy 1 d after surgery. The postoperative nutritionindicators （IgG, NB, TP, ALB）, MDA, SOD and inflammatory cytokines （IL-2, 6, 8 and TNF-α） were compared 1 d, 7 d after surgery. Results： The levels of IgG, NB, TP, ALB of EN groups were better than PN group 7 d after treatment. The levels of serum SOD of EN group were decreased 7 d after treatment, while MDA in EN group returned to preoperative levels 7 d after treatment. The levels of MDA of PN groups were significantly higher than that of EN group （P〈0.05）. The levels of IL-2, 6, 8 , and TNF-α of EN groups were higher than those of PN groups 7 d after treatment. The levels of IL-2, 6, 8 , and TNF-α of EN group were significantly lower than PN group （P〈0.05）. Oonclusion： EN can improve the body＇s nutrition, regulate serum SOD, MDA, reduce inflammatory stress response, and promote the body ＇s recovery.