Peng Chang-Bing, Li Wen-Zhong, Xu Rui, Zhuang Wen
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Gastrointestinal Surgery, Chengdu 363 Hospital, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 May;48(3):427-430.
To investigate the effects of early enteral immunonutrition on postoperative immune function and rehabilitation of gastric cancer patients with nutritional risk.
New hospitalized patients with gastric cancer were evaluated the nutrient status based on NRS 2002. The patients who scored between 3 to 5 points were randomized into two groups(30 cases for each group), and those in experimental group were given 7-d early postoperative enteral immune nutrition, those in control group were given normal nutrition. The immune indexes (CD3, CD4, CD8 and CD4/CD8) and nutritional indexes(transferrin, pre-albumin, albumin) were measured before operation and at the 3 and 7 day postoperatively. In addition, the first flatus time, gastrointestinal adverse reactions and complications, length of hospital stays were compared between the two groups.
The level of CD4/CD8 and transferrin, pre-albumin, albumin in experimental group were significantly higher than those in control group at the third and seventh day postoperatively (<0.05).Compared with the control group, the experimental group had shorter first flatus time after surgery, which were (63.5±7.3) h vs. (72.8±8.6 ) h respectively (<0.05).There were no statistically difference on pneumonia, anastomosis leakage, severe abdominal distension, inflammatory bowel obstruction and total postoperative hospitalization time between the two groups (>0.05).
Early enteral immunonutrition can effectively promote the recovery of nutritional status and immune function in gastric cancer patients with nutrition risk.
探讨早期肠内免疫营养对有营养风险的胃癌患者术后免疫功能及康复的影响。
对新入院的胃癌患者采用NRS 2002进行营养状况评估。将评分在3至5分的患者随机分为两组（每组30例），试验组患者术后早期给予7天肠内免疫营养，对照组给予普通营养。分别于术前、术后第3天和第7天检测免疫指标（CD3、CD4、CD8和CD4/CD8）和营养指标（转铁蛋白、前白蛋白、白蛋白）。此外，比较两组患者的首次排气时间、胃肠道不良反应及并发症、住院时间。
术后第3天和第7天，试验组CD4/CD8水平及转铁蛋白、前白蛋白、白蛋白水平均显著高于对照组（P<0.05）。试验组术后首次排气时间短于对照组，分别为（63.5±7.3）小时和（72.8±8.6）小时（P<0.05）。两组患者在肺炎、吻合口漏、严重腹胀、炎性肠梗阻及术后总住院时间方面差异无统计学意义（P>0.05）。
早期肠内免疫营养可有效促进有营养风险的胃癌患者营养状况及免疫功能的恢复。
