论文部分内容阅读
目的评价免疫增强型肠内营养对老年胃癌患者术后营养、免疫功能、炎性反应及并发症方面的影响。方法66例胃癌患者随机分成免疫增强肠内营养组(34例)与常规肠内营养组(32例),术后24 h给等热量、氮量肠内营养支持1周,比较术前1 d、术后第9天两组的营养、免疫指标、细胞因子的变化及并发症情况。结果术后免疫增强组前白蛋白与转铁蛋白均上升,而常规组均下降,两组差异有统计学意义(P<0.05),术后白蛋白两组均下降(P>0.05);术后两组IgMI、gA均升高且免疫增强组的升高更明显(P<0.05);术后免疫增强组的CD3+、CD4+及CD4+/CD8+均高于常规组(P<0.05),但CD8+无差异(P>0.05);术后两组IL-1α与IL-2均有下降,但差异无统计学意义(P>0.05);术后两组IL-6与TNF-α均升高,且常规组IL-6、TNF-α的升高更明显(P<0.05);术后免疫增强组感染性并发症发生率(11.8%)明显低于常规组(25%)(P<0.05)。结论老年胃癌患者术后给予免疫增强型肠内营养在提高蛋白质合成、减轻炎性反应、改善免疫功能及降低并发症方面优于常规的肠内营养。
Objective To evaluate the effects of immune-enhanced enteral nutrition on postoperative nutrition, immune function, inflammatory response and complications in elderly patients with gastric cancer. Methods Sixty-six patients with gastric cancer were randomly divided into three groups: immunocompromised enteral nutrition group (n = 34) and routine enteral nutrition group (n = 32) After 9 days, the nutrition and immune indexes, changes of cytokines and complications of the two groups were observed. Results The levels of albumin and transferrin increased in both groups before and after operation, but decreased in the conventional group (P <0.05). The albumin in both groups decreased after operation (P> 0.05) The IgM and gA in the latter two groups were significantly higher than those in the normal group (P <0.05), but the levels of CD8 +, CD4 + and CD8 + in the immune enhancement group were significantly higher than those in the conventional group There was no difference between the two groups (P> 0.05). The levels of IL-1α and IL-2 in both groups decreased after operation, but the difference was not statistically significant (P> 0.05) (P <0.05). The incidence of infectious complications in postoperative immune enhancement group (11.8%) was significantly lower than that in routine group (25%) (P <0.05) . Conclusion The elderly patients with gastric cancer after giving immune-enhanced enteral nutrition in improving protein synthesis, reduce inflammatory response, improve immune function and reduce complications than conventional enteral nutrition.