Betzler M, Gollwitzer M, Flad H, Herfarth C
Chir Forum Exp Klin Forsch. 1979:161-4.
In a pilot study, the distribution of lymphocyte subpopulations in the peripheral blood and skin tests with recall antigens have been examined in 42 patients with gastrointestinal cancer before and during a perioperative parenteral hyperalimentation. Concerning the calories and the concentrations of amino acids and carbohydrates, two different solution regimens were applied. During parenteral nutrition with 2400 and 2200 kcal especially the absolute numbers of lymphocyte subpopulations increase reflecting the changes of total lymphocyte count. There was no marked difference between the 2 groups. Both solutions are qualified to balance the preoperative catabolic situation indicated by preoperative lymphopenia. This kind of parenteral nutrition did not influence the patient's cellular immunological status which was tested by 3 recall antigens. It must, however, be considered that the physical i.e. nutritional situation of the patients was not reduced to an extent where the immunological status was impaired. Our results suggest that in the perioperative period cancer patients should be supported by hypercaloric parenteral nutrition. On the other hand more sensitive immunological tests such as DNCB for skin testing and functional assays for in vitro tests are necessary to assess the effects of this kind of therapy.
在一项初步研究中，对42例胃肠道癌患者在围手术期胃肠外高营养治疗前及治疗期间的外周血淋巴细胞亚群分布和回忆抗原皮肤试验进行了检查。关于热量以及氨基酸和碳水化合物的浓度，采用了两种不同的溶液方案。在给予2400千卡和2200千卡的胃肠外营养期间，尤其是淋巴细胞亚群的绝对数量增加，反映了总淋巴细胞计数的变化。两组之间无明显差异。两种溶液均有资格平衡术前淋巴细胞减少所表明的术前分解代谢状态。这种胃肠外营养并未影响通过3种回忆抗原检测的患者细胞免疫状态。然而，必须考虑到患者的身体即营养状况并未降低到免疫状态受损的程度。我们的结果表明，在围手术期癌症患者应接受高热量胃肠外营养支持。另一方面，需要更敏感的免疫测试，如用于皮肤试验的二硝基氯苯和用于体外试验的功能测定，以评估这种治疗方法的效果。
