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目的:探讨EN对食管癌病人术后应激反应和肠道屏障功能的影响。方法:将54例食管癌切除术病人随机分成PN组(n=28例)和EN组(n=26例)。分别检测手术前后不同时段的血清细胞因子、T细胞亚群、NK细胞活性、蛋白质和内毒素水平等。结果:血清ALB、PA和FT等营养指标术后均显著降低,但两组间差异无显著性意义。术后第1和第3天,两组病人血清IL-6水平较术前均显著升高(P<0.01),EN组显著低于PN组。血清IL-10与IL-6变化相似。术后两组CD3+、CD4+、CD4+/CD8+均显著降低(P<0.01),术后第10天EN组显著高于PN组(P<0.05)。术后第10天EN组NK细胞活性明显超过PN组。EN组血清内毒素水平术后显著低于PN组(P<0.05)。结论:EN支持对食管癌术后病人能减少血清内毒素、抑制过度炎症反应和维持机体免疫功能。
Objective: To investigate the effect of EN on postoperative stress response and intestinal barrier function in patients with esophageal cancer. Methods: 54 patients with esophagectomy were randomly divided into PN group (n = 28) and EN group (n = 26). Serum cytokines, T cell subsets, NK cell activity, protein and endotoxin levels were measured before and after surgery. Results: Serum ALB, PA and FT and other nutritional indicators were significantly reduced postoperatively, but no significant difference between the two groups. The levels of serum IL-6 in the two groups were significantly higher than those before the operation (P <0.01) on the 1st and 3rd postoperative days, but were significantly lower in the EN group than those in the PN group. Serum IL-10 and IL-6 changes similar. After operation, the levels of CD3 +, CD4 + and CD4 + / CD8 + in both groups were significantly decreased (P <0.01). On the 10th postoperative day, the levels of CD3 +, CD4 + and CD8 + in EN group were significantly higher than those in PN group (P <0.05). On the 10th day after operation, the NK cell activity in EN group was significantly higher than that in PN group. The level of serum endotoxin in EN group was significantly lower than that in PN group after operation (P <0.05). CONCLUSIONS: EN support for postoperative patients with esophageal cancer can reduce serum endotoxin, inhibit excessive inflammatory response and maintain immune function.