术后肠内免疫营养支持在营养不良的胃肠道肿瘤患者中的应用研究

目的：探讨术后肠内免疫营养支持疗法在伴有营养不良的胃肠道肿瘤患者中的应用价值.方法：依据标准选择研究对象,对 112例营养不良的胃肠道恶性肿瘤患者分别采取肠内免疫营养支持 （ 观察组 ） 和普通肠内营养支持 （ 对照组 ） 方式进行治疗,观察对比两组患者的免疫学检测指标以及不良反应发生率、并发症发生情况以及平均住院时间.结果：术后 1 d,患者的淋巴细胞、NK 细胞、CD3、CD4、CD4/CD8、IgA、IgG、IgM、IgE、C3、C4、CH50 免疫学指标与术前比较明显下降,且差异具有统计学意义 （P〈0.05）.术后 9 d,观察组淋巴细胞、NK 细胞、CD3、CD4、CD4/CD8、C3、C4、CH50 几项指标回升幅度明显高于对照组,差异有统计学意义 （P〈0.05）;同时,观察组 CRP 迅速下降,明显低于对照组,差异有统计学意义 （P〈0.05）.观察组不良反应发生率低于对照组,但差异无统计学意义 （P〉0.05） ;观察组并发症发生率明显低于对照组,且差异有统计学意义 （ P〈0.05）;观察组平均住院天数为 （8.6±1.4）d,对照组为 （10.2±1.1）d,两组比较差异有统计学意义 （P〈0.05）.结论：对于合并营养不良的胃肠道恶性肿瘤患者,选择肠内免疫支持疗法进行治疗具有较高的应用价值 ;与普通肠内营养治疗相比,在恢复机体免疫功能、减少术后并发症及缩短平均住院时间等方面更具优势.

Applied Research of Enteral Immune and Nutritional Support in Malnourished Patients with Gastrointestinal Cancer

Objective： To explore the application value of enteral immune and nutritional support in gastrointestinal cancer patients with malnutrition. Method： The subjects, selected according to the standard enteral immune and nutritional support（~tudy group） and ordinary enteral nntrition（control group） to treatment of 112 cases of malnutrition in patients with malignant tumors of the gastrointestinal tract swelling, were taken to observe the two groups. To compare the patients with immunological detection of indicators, and incidence of adverse reactions, complications and the average length of stay. Result： The postoperative 1 day, the patient＇ s lymphocytes, NK cells, CD3, CD4 and CD4/CD8, IgA, and IgG and IgM, IgE, C3, C4, and of CH50 immune markers compared with preoperative decreased, and the difference was statistically significance（P〈0.05）. 9 days of postoperative, lymphocytes, NK ceils, CD3, CD4, CD4/CD8, C3, C4, and of CH50 several indicators of recovery rate in study group was significantly higher than control group, the difference was statistically significant（P〈O.05）, the CRP in study group was lower than the control group, the difference was statistically significant（P〈0.05）. The incidence of adverse reactions in study group was lower than the control group, but the difference was not statistically significant（P〉0.05）. The incidence of complications in study group was significantly lower than the control group, and the difference was statistically significant（P〈0.05）. The average hospital days were （8.6＋ 1.4）days in study group, the control group were （10.2＋ 1.1）days, the difference was statistically significant in the two groups（P〈0.05）. Conclusion： Enteral immune and nutritional support has a high value for the merger malnourished patients with gastrointestinal cancer, compared with enteral nutrition therapy, restoring immune function and reduce postoperative concurrent disease and shorten the average length of stay more competitive.