围手术期肠内营养对老年胃肠恶性肿瘤患者免疫功能的影响

目的 探讨围手术期肠内营养对老年胃肠道恶性肿瘤患者免疫功能的影响.方法 选择80例老年胃肠道恶性肿瘤患者,按随机数字表法分为试验组(给予肠内营养)和对照组(给予肠外营养),每组40例.在术前5、1 d和术后1、7 d抽取外周静脉血,检测自然杀伤细胞(NKC)活性、T淋巴细胞亚群(CD3、CD4、CD8)和血清免疫球蛋白(Ig)G、IgA、IgM的变化.结果 试验组术后7d NKC活性(40.1±4.9)%]、CD3(69.40±7.10)%]、CD4(39.20±5.83)%]、IgA(2.94±0.56)g/L]、IgM(1.34±0.72)g/L]较术前5 d均有显著升高(P＜0.05),同时与对照组术后7 d(26.4±4.9)%、(61.40±8.32)%、(29.20±5.65)%、(1.72±0.76)gL、(0.97±0.89)g/L]比较差异均有统计学意义(P＜0.05).结论 围手术期应用肠内营养能提高老年胃肠道恶性肿瘤患者的营养水平及免疫功能,降低手术风险和减少术后并发症.

Effects of perioperative enteral nutrition on host immunologic function in elderly patients with gastrointestinal tract malignant tumor

Objective To evaluate the effects ofperioperative enteral nutrition on host immunologic function in elderly patients with gastrointestinal tract malignant tumor. Methods Eighty elderly patients with gastrointestinal tract malignant tumor were divided into two groups by random digits table with 40 cases each: experimental group was given enteral nutrition and control group was given parenteral nutrition.Peripheral blood samples were collected at the fifth and the first day before operation, and the fust and the seventh day after operation to examine the NK cell,T-lymphocyte subsets (CD3, CD4,CD8) and immunoglobulin (lgG, lg A, IgM ). Result There were significantly increased in NK cell (40.1 ± 4.9)%], CD3(69.40 ±7.10)%], CD4(39.20 ± 5.83)%], IgA(2.94 ±0.56) g/L] and IgM(1.34 ±0.72) g/L] of experimental group compared with those of control group (26.4 ± 4.9 )%, ( 61 .40 ± 8.32)%, ( 29.20 ± 5.65 )%, ( 1.72 ±0.76) g/L, (0.97 ± 0.89 ) g/L] (P ＜ 0.05 ). Conclusion The application of enteral nutrition in perioperative period can improve the immunologic function of elderly patients with gastrointestinal tract malignant tumor,reduce surgical risk and postoperative complications.