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目的:探讨低氮低热量肠外营养对胃癌术后病人免疫功能的影响。方法:将87例胃癌病人双盲、随机分为全胃肠外营养组(TPN,44例)和低氮低热量肠外营养组(HHPN,43例)。病人于手术前1 d、术后第1和第8天分别检测外周血淋巴细胞计数(TLC)、免疫球蛋白(IgGI、gMI、gA)、T淋巴细胞亚群(CD4、CD8、CD4/CD8)和人类白细胞抗原DR(HLA-DR)水平,观察比较两组胃癌术后病人的营养状况、免疫功能和术后感染性并发症等指标的差异。结果:两组病人营养状况无明显差异,HHPN组病人术后第8天TLCI、gG、CD4、CD4/CD8和HLA-DR的表达与TPN组比显著升高(P<0.05)。术后感染性并发症的发生率低于TPN组。结论:使用低氮低热量肠外营养更有利于胃癌病人术后早期免疫功能的恢复和减少感染性并发症的发生率。
Objective: To investigate the effect of low-nitrogen and low-calorie parenteral nutrition on immune function of postoperative patients with gastric cancer. Methods: 87 patients with gastric cancer were double-blind and randomly divided into total parenteral nutrition group (TPN, 44 cases) and low-nitrogen hypocaloric parenteral nutrition group (HHPN, 43 cases). The levels of peripheral blood lymphocyte (TLC), immunoglobulin (IgGI, gMI, gA), T lymphocyte subsets (CD4, CD8, CD4 / CD8) were measured on the first day before operation and on the first day and the eighth day after operation. ) And human leukocyte antigen DR (HLA-DR) were measured. The nutritional status, immune function and postoperative infectious complications were compared between the two groups. Results: There was no significant difference in nutritional status between the two groups. The expression of TLCI, gG, CD4, CD4 / CD8 and HLA-DR in the HHPN group was significantly higher than that in the TPN group on the 8th postoperative day (P <0.05). The incidence of postoperative infectious complications was lower than that of the TPN group. Conclusion: The use of low-nitrogen and low-calorie parenteral nutrition is more conducive to the recovery of early postoperative immune function and reduce the incidence of infectious complications in patients with gastric cancer.