肠内营养加四味参芪口服液管饲对食管癌根治术后患者肠道功能及免疫功能影响的临床研究

目的：观察肠内营养加四味参芪口服液管饲对食管癌术后患者肠道功能及免疫功能的影响。方法：选择我院于2008年1月至2012年3月期间接受食管癌根治术的84例患者作为研究对象,将84例患者按随机表法分成两组各42例,治疗组行食管癌根治术后肠内营养加四味参芪口服液管饲（EN）,对照组行食管癌根治术后静脉营养（PN）。分别观察术后肛门排气、排便时间和肠鸣音正常的时间,术前、术后7天、术后14天监测外周血T淋巴细胞亚群（CD3,CD4,CD8,CD4/CD8）、B淋巴细胞、NK细胞活性。结果：两组患者均按计划完成治疗。治疗组术后平均肠道功能恢复时间12~24小时,对照组平均肠道功能恢复时间36~72小时,治疗组肠道功能恢复时间明显优于对照组（P〈0.05）。对照组和治疗组术后7天外周血T淋巴细胞亚群（CD3,CD4,CD8,CD4/CD8）、B淋巴细胞、NK细胞活性均明显下降,两者之间无明显差异（P〉0.05）。治疗组术后14天恢复到术前水平;而对照组术后14天有所恢复,但仍明显低于术前水平,两者之间有明显差异（P〈0.05）。结论：肠内营养加四味参芪口服液管饲对食管癌术后患者的肠道功能和免疫功能有良好的调节作用,使得患者的肠道功能和免疫功能迅速从手术打击中恢复,尽快进入内科综合治疗和康复治疗阶段。

Effect Observation of Tube Feeding with Enteral Nutrition Adding Siwei Shenqi Oral Liquid on the Influence of Intestinal Function and Immunologic Function after Esophagectomy

Objective： To investigate the influence of intestinal function and immunologic function for Siwei Shenqi Oral Liquid through tube feed after Esophagectomy. Methods： To study 84 patients in thoracic surgery of our hospital during the period from 2008 January to 2012 March. They were accepted the Esophagectomy because of esophageal cancer. 84 patients were randomly divided into 2 groups with 42 cases in each group. Treatment group of esophageal cancer postoperative were treated by enteral nutrition plus Siwei Shenqi Oral Liquid through tube feeding（ EN）,the controlled group of esophageal cancer postoperative were treated parenteral nutrition（ PN）. The anal exhaust time and defecated time and bowel sounds were observed. We monitored the difference about peripheral blood for T lymphocyte surface marker and B lymphocyte surface markers,the number of NK cells on preoperative and 7 day and 14 day postoperative. Results： Two groups of patients were accomplished according to plan treatment. The Intestinal function of the EN group recovered at 12 ~ 24 hours postoperative. The Intestinal function of the PN group recovered at 36 ~ 72 hours postoperative. Intestinal function recovery time of EN group was better than that of the PN group（ P 0. 05）. 7 days after the operation,T lymphocyte surface marker,B lymphocyte surface marker,and the number of NK cells decreased significantly both of the EN group and the PN group at the peripheral blood,there were no significant differences between them（ P 0. 05）. 14 days after the operation,T lymphocyte surface marker,B lymphocyte surface marker,and the number of NK cells recovered to the preoperative level at the EN group. 14 days after the operation,T lymphocyte surface marker,B lymphocyte surface marker,and the number of NK cells increased,but still lower than the preoperative level,there was significant difference between them（ P 0. 05）. Conclusions： Enteral nutrition plus Four ShenQi Oral Liquid through tube feeding for patients with esophageal carcinoma after operation,intestinal function and immunologic function can rapidly recovered. And that maybe help the patients accept the comprehensive treatment as soon as possible.