胃肠道恶性肿瘤术后早期肠内营养与肠外营养对照研究

目的讨论肠内营养与肠外（静脉）营养对胃肠道恶性肿瘤患者术后营养状况、术后并发症、免疫功能、及住院时间的影响。方法针对我院2009-2011年间92例确诊胃肠道恶性肿瘤并行手术治疗患者随机分为：观察组50例（肠内营养组）和对照组42例（肠外营养组）,在术前1d及术后3d和7d抽取静脉血,检测淋巴细胞总数、T淋巴细胞亚群（CD3、CD4、CD8、CD4/CD8）和体重、血清白蛋白、前白蛋白等营养状况,并比较两组的并发症发生率、住院时间、发热时间等指标。结果观察组与对照组患者体重均有下降,但观察组患者的白蛋白和前白蛋白升高水平均高于对照组;两组患者术后的淋巴细胞总数、CD3＋、CD4＋、CD8＋细胞、CD4＋/CD8＋比值降低,但是观察组的回升高于对照组;且观察组的并发症发生率明显低于对照组、发热时间及住院时间明显短于对照组。结论胃肠道恶性肿瘤术后早期肠内营养较肠外营养更具优越性,可降低术后并发症发生率,缩短住院时间,能提高患者的营养水平及免疫功能。

The control study of Gastrointestinal cancer treated by early postoperative enteral nutrition and parenteral nutrition

Objective To discuss the differences between enteral nutrition and parenteral nutrition （vein） in the gas-trointestinal tract malignant tumor patients who were suffered by operations on postoperative nutritional status,the postoperative complications,immune function,and the influence of the length of hospital stay. Methods 2009-2011 92 cases which were diagnosed gastrointestinal malignant tumor treated with surgery operations were randomly divided in to two teams ： observation group of fifty cases （enteral nutrition team） and the control group 42 patients （parenteral nu- trition team）, in the 1 day preoperative and 3,7 days postoperative extraction venous blood,Detection venous blood for lymphocyte total,T lymphocyte subsets （CD3 ,CD4, CD8 and CD4/CDS） and body weight, serum albumin, prealbumin and nutritional status,in the l.ast day preoperative and 3th,7th day postoperative extraction venous blood. The compared with two groups by complications,length of hospital stay, heating time and so on. Results The patients weight de- creased significantly in both two teams, but the observation group of patieffts with albumin and prealbumin elevated lev- el are higher than those in the control group; TWO groups of patients total lymphocyte, CD3＋, CD4＋, CD8＋ cells, CD4＋/CD8＋ ratio is reduced contrast with preoperative,but the observation group is higher than those in the control group;The observation group and the control group was significantly lower than the complications, heating time and hospital stay obviously less than control group. Conclusion postoperative gastrointestinal tumor which is given early enteral nutrition has more advantages than parenteral nutrition, which can reduce the incidence of postoperative complications,shorten hospitalization time,can improve the patienfs nutrition level and immune function.