全胃切除患者术后早期免疫增强型肠内营养作用.docVIP

全胃切除患者术后早期免疫增强型肠内营养作用 　 作者：郑建勇, 王为忠, 管文贤，陈冬利，张崇广 【关键词】 胃切除术 Effect of postoperative immuneenhanced enteral nutrition in patients with total gastrectomy 　　【Abstract】 AIM: To study the effect of postoperative immuneenhanced enteral nutrition support on the nutritional status, immune function and inflammatory responses in patients with total gastrectomy. MEHTODS: Fiftytwo gastric cancer patients with total gastrectomy were randomly divided into 2 groups: Enteral nutrition group (EN group, n=26) and immuneenhanced enteral nutrition group (experiment group, n=26). Calorie and nitrogen of the same quantity were provided for both groups from the first day after surgery. The patients in EN group received conventional enteral nutrition support with Nutrison and the patients in experiment group received immuneenhanced enteral nutrition support with Stresson for 7 d, respectively. The levels of total protein, albumin, prealbumin, IgG, IgA, IgM, CD3, CD4, CD8, CD4/CD8, IL2 and TNFα were measured preoperatively and on day 1 and 8 after operation. RESULTS: The total protein, albumin and prealbumin had no difference between the two groups. On the 8th day after operation, the levels of IgG, IgA, IgM, CD3, CD4 and CD4/CD8 were significantly higher in experiment group than those in EN group (Plt;0.05), while TNFα was significantly lower in experiment group than that in EN group (Plt;0.05). CONCLUSION: Early postoperative immuneenhanced enteral nutrition support can improve the immune function of gastric cancer patients with total gastrectomy and alleviate inflammatory responses. 　　【Keywords】 enteral nutrition; gastrectomy; immunity; inflammatory response 　　【摘要】 目的： 研究全胃切除患者术后早期免疫增强型肠内营养支持对机体营养、免疫功能及炎症反应的影响. 方法： 选择进展期胃癌根治性全胃切除患者52例，随机分为两组：免疫增强型肠内营养组（实验组）和常规肠内营养组（EN组）. 两组患者均从术后第1日起从营养管给予等热量、等氮量的肠内营养制剂. 实验组使用免疫增强型肠内营养制剂Stresson，EN组使用常规的肠内营养制剂能全力，共7 d. 于术前及术后第1日、第8日分别抽取外周血测定血清总蛋白，白蛋白，前白蛋白，IgG, IgA, IgM, T淋巴细胞亚群，IL2及TNFα. 结果： 研究期间两组总蛋白、白蛋白、前白蛋白及氮平衡均无显著差异. 术后第8日实验组的IgG, IgM, IgA, CD3, CD4