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目的 探讨肠内营养(EN)干预对腹部手术患者营养状态和肠粘膜屏障的效果.方法 纳入2013年3月-2015年3月广州市第一人民医院择期腹部手术患者88例作为研究对象,采用随机数字表法随机分为EN组和全肠外营养(PN)组,每组44例,观察两组术前1 d、术后8 d白蛋白(ALB)、前白蛋白(PA)、总蛋白(TP)、血红蛋白(Hb)、血清内毒素、二胺氧化酶(DAO)、乳果糖(L)/甘露醇(M)比值、排气时间、住院时间及不良反应发生率.结果 两组术后8 d ALB、TP、Hb与同组术前1 d对比无明显差异(P>0.05),且组间同时点ALB、TP、Hb比较差异亦无统计学意义(P>0.05).术后8 d,两组CD4+、CD4+/CD8+、内毒素、DAO、L/M较术前1 d升高(P0.05). 8 d after surgery,CD4+,CD4+/CD8+,endotoxin,DAO and L/M in the two groups were significantly higher than those of 1 d before surgery(P<0.05). In EN group,PA,CD4+and CD4+/CD8+8 d after surgery were significantly higher than those in PN group,while CD8+,DAO,L/M and endotoxin were significantly lower (P<0.05). The exhaust time and length of hospital stay of EN group were significantly shorter than PN group (P<0.05). Conclusion EN can improve the nutritional status ,improve the immunity and protect intestinal mucosal barrier in patients undergoing abdominal surgery.