早期肠内营养对胃恶性肿瘤患者术后免疫功能和炎症指标的影响

目的:探究早期肠内营养对胃恶性肿瘤患者术后免疫功能和炎症指标的影响。方法:采用随机对照研究，选取2014年6月至2017年6月我院收治住院的胃恶性肿瘤并行手术治疗的患者82例，按照随机数字法1∶1随机分成治疗组41例和对照组41例。其中，治疗组予早期肠内营养治疗，对照组予肠外营养治疗。比较两组治疗前后的营养状态、炎症指标、免疫指标和术后情况。结果:两组在性别、年龄、病程等一般资料比较上，差异无统计学意义（P＞0.05）。治疗组治疗后的白蛋白和前白蛋白水平高于治疗前（P＜0.05），且治疗组治疗后的白蛋白、前白蛋白水平显著高于对照组治疗后（P＜0.05）。治疗组治疗后的白介素-6(IL-6)水平显著低于对照组治疗后（P＜0.05）。两组治疗后的CD4+、CD8+和CD4+/CD8+水平均低于治疗前（P＜0.05），但是治疗组治疗后的CD4+和CD4+/CD8+水平显著高于对照组治疗后（P＜0.05），而两组治疗后的CD8+水平差异无统计学意义（P＞0.05）。治疗组术后排气时间和住院时间显著低于对照组（P＜0.05），两组在术后伤口感染和术后伤口愈合不良方面差异无统计学意义（P＞0.05）。结论:早期肠内营养有助于早期改善胃恶性肿瘤患者术后的胃肠功能和营养状态，减轻患者的炎症反应，提高患者的免疫功能。

The effect of early enteral nutrition on postoperative immune function and inflammation markers of patients with malignant gastric tumor

Objective:To assess the effect of early enteral nutrition on postoperative inflammation markers and immune function of patients with malignant gastric tumor.Methods:There were 82 patients with malignant gastric tumor were randomly divided into treatment group（n=41) and control group（n=41).The treatment group was given earlyenteral nutrition therapy,and the control group was given parenteral nutrition therapy.The nutrition index,inflammatory indexes,immune parameters and postoperative situation were compared between two group.Results:The clinical data such as gender,age,complication and course of the disease were no significant differences between two group（P＞0.05).After 7 days therapy,the serum albumin and the serum prealumin were higher than that before-intervention in treatment group(P＜0.05).And the serum albumin and the serum prealumin were sinificantly higher than that in the control group after 7-day intervention.The IL-6 in the treatment group was sinificantly lower than that in control group after 7-day intervention（P＜0.05).The CD4+,CD8+ and CD4+/CD8+ were decreased after operation（P＜0.05).However,after 7-day treatment,the CD4+ and CD4+/CD8+ in treatment group were higher than the control group（P＜0.05).But the CD8+ showed no sinificant differences between two group after intervention（P＞0.05).The postoperative exhaust time and the hospitalized time were less than the control group（P＜0.05).But the postoperative infection and the wound separation were no sinificant differences between two group（P＞0.05).Conclusion:The earlyenteral nutrition not only can effectively improve the digestive function,nutritional status and the immunity of the body,but aslo can reduce inflammation of patients with malignant gastric tumor.