胃肠道肿瘤患者术后肠内营养对免疫和肠功能的影响

目的探讨术后肠内营养对胃肠道肿瘤患者营养免疫和肠功能的影响。方法回顾性分析在我院诊治的胃肠肿瘤经手术治疗的50例患者的临床资料,其中术后采用肠内营养者20例,采用肠外营养者30例,比较两组患者在术前、术后营养状态指标以及术前和术后第7天外周血管T细胞亚群变化,肠黏膜通透性采用术前、术后5d、术后9d尿乳果糖/甘露醇比值评价,并比较两组患者肛门排气时间以评价肠功能恢复情况。结果术后第5天和术后第9天两组前白蛋白和纤维连接蛋白有显著差异(P<0.05)。肠内营养组在术后第7天细胞免疫相关指标已经恢复到术前水平,而肠外营养组还显著低于术前水平。术后第5天和第9天肠内营养组患者肠道黏膜通透性显著低于肠外组(P<0.05),而肠内营养组患者肠道排气时间显著早于肠外营养患者(P<0.05)。结论胃肠道肿瘤患者术后给予肠内营养能够促进营养不良的恢复,改善免疫功能以及促使肠道功能的恢复。

Effect of gastroenteric tumor postoperative enteral nutrition support on immunologic function and intestinal function

Objective To discuss effect of gastroenteric tumor postoperative enteral nutrition support on immunologic function and intestinal function. Methods Selected 50 cases with gastroenteric tumor after operation, clinical data were collected. Twenty cases received EN and 30 cases received PN. Condition of nutrition, change of T cell subset, intesti- nal permeability, intestinal function were Compared. Results At 5 d and 9 d after operation, prealbumin and fibronec- tion of two groups had significant difference （P 〈0.05）. At 7d after operation, T cell subset of EN group had recovered the level before operation, but T cell subset of PN group was significant lower than that of before operation. Anus ex- hausting time of EN group was earlier than PN group （P 〈0.05）. Conclusion Enteral nutrition for gastroenteric tumorb can promote recovery of malnutrition, improve immunologic function and intestinal function.