摘要
目的探讨术后应用肠内免疫营养对伴营养不良的胃肠道肿瘤患者术后炎性反应和免疫功能的影响。方法前瞻性收集2008年1月至2010年6月间河北省沧州市人民医院普通外科106例合并营养不良的胃肠道恶性肿瘤手术患者．按随机数字表法分为肠内免疫营养组（53例）和普通肠内营养组（53例）。于术前5d、术后1d和9d分别进行免疫学指标和急性相反应蛋白的检测。结果两组患者手术情况及术前免疫学指标的差异均无统计学意义（均P〉0．05）。术后9d，免疫营养组免疫学指标C04、CD4／CD8、IgG、淋巴细胞、NK细胞及补体c3、c4和CH50水平均高于普通营养组：血清C反应蛋白水平则低于普通营养组，差异均有统计学意义（P〈0．05）。免疫营养组术后感染并发症发生率为3．8％（2／53），明显低于普通营养组的15．1％（8／53）（P〈0．05）：术后住院时间为（8．1±1．1）d，明显短于普通营养组的（9．2±2.1）d（P〈0．05）。结论对于合并营养不良的胃肠道恶性肿瘤患者．应用肠内免疫营养可减轻术后创伤和炎性反应．改善机体免疫功能，从而降低术后感染并发症发生率。
Objective To explore the effects of postoperative enteral immunonutrition on inflammatory response and immunologic function in patients with gastrointestinal tumor. Methods Clinical data of 106 gastrointestinal malignant tumor patients with malnutrition who were treated in the Department of General Surgery, the People＇s Hospital of Cangzhou in Hebei province from January 2008 to June 2010 were prospectively collected. Patients were randomized into two groups, including enteral immunonutrition group （n=53） and common enteral nutrition group （n=53）. Related immunological indices and C-reaction protein were measured on preoperative day 5 and postoperative day 1 and 9. Results The general information and preoperative immunological indices were comparable between the two groups （P〉0.05）. On postoperative day 9, levels of CD4, CD4/CD8, IgG, lymphocyte, NK cells, and complement C3, C4, and CH50 in the enteral immunonutrition group were higher than those in common enteral nutrition group. Serum C-reaction protein level was lower than that in control group, and the difference was statistically significant （P〈0.05）. Postoperative infection rate was 3.8% （2/53） in enteral immunonutrition group, significantly lower than that in control group with an infection rate of 15.1%（8/53）（P〈0.05）. The mean postoperative hospital stay of the two groups were （8.1±1.1） d and （9.2±2.1） d, respectively, and the difference was statistically significant（P〈0.05）. Conclusion For gastrointestinal malignant tumor patients with malnutrition, the use of enteral immunonutrition can alleviate the postoperative trauma and inflammatory response, improve the immune function, thus can reduce the occurrence of postoperative infection, and accelerate patient recovery.
出处
《中华胃肠外科杂志》
CAS
北大核心
2011年第10期799-802,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
胃肠道肿瘤
营养不良
肠内营养
免疫营养
Gastrointestinal neoplasms
Malnutrition
Enteral nutrition
Immunonutrition
