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目的观察食管癌术后肠外营养支持早期机体免疫功能的变化。方法对３０例食管癌病人根治术后，随机分为ＰＮ组和非ＰＮ组进行对比观察，分别在手术前、术后１天及术后８天检测ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３、Ｔ细胞亚群、ＮＫ细胞活性和ＩＬ－２等的改变。结果食管癌病人术前均有不同程度的免疫功能低下，术后第１天，ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３较术前显著下降，术后１周ＰＮ组ＩｇＧ、ＩｇＡ、Ｃ３恢复较快，达到或超过术前水平，与非ＰＮ组比较差异有显著意义（Ｐ＜００１）。ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值术后第１天下降明显，而ＰＮ组术后１周迅速恢复并明显超过术前水平，与非ＰＮ组相比差异有显著意义（Ｐ＜００１）。ＮＫ细胞活性术后第１天也明显降低，ＩＬ－２显著减少。术后１周ＮＫ细胞活性ＩＬ－２ＰＮ组较非ＰＮ组恢复较快，差异有显著意义（Ｐ＜００１）。结论食管癌病人术后早期免疫功能低下，应用ＰＮ包括脂肪乳剂可以有效地改善机体的免疫功能，并相应降低术后并发症和病死率。
Objective To observe the changes of immune function in early stage after parenteral nutrition support for esophageal cancer. Methods Thirty patients with esophageal cancer were randomly divided into PN group and non-PN group. IgG, IgA, IgM, C3, and T cells were detected before surgery, 1 day after surgery, and 8 days after operation. Changes in population, NK cell activity and IL-2, etc. Results All patients with esophageal cancer had low preoperative immune function. On the first postoperative day, IgG, IgA, IgM, and C3 were significantly lower than before surgery. PN, IgG, IgA, and C3 recovered rapidly in the PN group 1 week after surgery. Or more than the preoperative level, compared with the non-PN group difference was significant (P <0 01). The ratios of CD+3, CD+4, and CD+4/CD+8 decreased significantly on the first postoperative day, while those in the PN group recovered rapidly and significantly exceeded the preoperative level one week after surgery, which was significantly different from the non-PN group (P<0.01). The NK cell activity was also significantly reduced on the first postoperative day, and IL-2 was significantly reduced. The activity of NK cells in the IL-2PN group was faster than that in the non-PN group at 1 week after surgery (P<001). Conclusion The early postoperative immune function of patients with esophageal cancer is low. The use of PN including fat emulsion can effectively improve the body’s immune function, and accordingly reduce postoperative complications and mortality.