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目的研究术后早期肠内营养对胃癌患者术后营养状况和免疫功能的影响。方法将60例胃癌患者随机分为肠内营养(EN)组和肠外营养(PN)组各30例。PN组术后行TPN支持;EN组术后第1天起经鼻饲管输注能全力。分别于术前及术后8 d测体重、血清蛋白质、Hb、免疫球蛋白及外周血T淋巴细胞亚群(CD+3、CD+4、CD+8、CD+4/CD+8)等。临床观察生命体征、胃肠道功能恢复情况及各种不良反应。结果EN组术后8 d体重(60.5±5)kg,高于PN组的(58.8±3)kg(P<0.05);肛门排气时间EN组(62±10)h,较PN组(74±15)h显著缩短(P<0.05)。PN组术后CD+3、CD+4、CD+4/CD+8稍下降,而EN组术后CD+3、CD+4、CD+4/CD+8与术前相比无显著变化。术后CD+4/CD+8EN组(1.4±0.3),高于PN组(1.2±0.2),两组比较有统计学意义(P<0.05)。结论早期肠内营养可改善胃癌患者术后营养状态及免疫功能。
Objective To study the effect of early postoperative enteral nutrition on nutritional status and immune function in patients with gastric cancer. Methods Sixty patients with gastric cancer were randomly divided into enteral nutrition (EN) group and parenteral nutrition (PN) group, 30 cases each. The patients in PN group underwent TPN after operation. The EN group received full transnasal feeding on day 1 postoperatively. Body weight, serum protein, Hb, immunoglobulin and peripheral blood T lymphocyte subsets (CD + 3, CD + 4, CD + 8, CD + 4 / CD + 8) were measured before and 8 days after operation . Clinical observation of vital signs, gastrointestinal function recovery and various adverse reactions. Results The body weight (60.5 ± 5) kg in EN group was significantly higher than that in PN group (58.8 ± 3) kg (P <0.05) after 8 days and 62 ± 10 days in EN group ± 15) h was significantly shorter (P <0.05). There was a slight decrease of CD + 3, CD + 4 and CD + 4 / CD + 8 in PN group after operation, but there was no significant change in postoperative CD + 3, CD + 4 and CD + 4 / . Postoperative CD + 4 / CD + 8EN group (1.4 ± 0.3), higher than the PN group (1.2 ± 0.2), the two groups was statistically significant (P <0.05). Conclusion Early enteral nutrition can improve the nutritional status and immune function of gastric cancer patients.