Objective To investigate the effect of early enteral nutrition or parenteral nutrition on immune function and nutritional status in patients after radical gastrectomy for gastric cancer.Methods A total of 120 patients with gastric cancer treated in our hospital from January 2013 to December 2015 were selected and divided into experimental group and control group according to random number table method.The control group was treated with parenteral nutrition, and the experimental group was given early enteral nutrition support.The immune function and nutritional status of the two groups were compared.Results On the first day after operation, the activity of the immune cells in the two groups was weaker than that before operation (P<0.05),including CD3+, CD4+, CD4+/CD8+ and NK.On the seventh day after operation, the activity of the immune cells in the experimental group was similar to the preoperative level (P>0.05).The activity of the immune cells in control group was significantly lower than those of the preoperative level and the experimental group (P<0.05).The fever time, recovery time of intestinal function, exhaust time and hospitalization time in the experimental group were significantly shorter than those of the control group (P<0.05).On the first day after operation, the contents of albumin and prealbumin in two groups were(25.2±5.8)g/L, (136.7±18.8)g/L and (25.5±6.0)g/L, (134.3±17.7)g/L, which were lower than those of two groups before operation.On the seventh day after operation, the contents of prealbumin and albumin in experimental group were (172.5±22.8) g/L and (37.6±7.7) g/L, which were significantly higher than those of control group (P<0.05).The complication rate of the experimental group was 11.7%, which was significantly lower than that of control group (28.3%),and the difference was statistically significant(P<0.05).Conclusion Early enteral nutrition therapy can effectively improve the nutritional status and immune function of patients with gastric cancer.It is worth to be popularized in clinical use.%目的 探讨早期肠内营养或肠外营养治疗对胃癌根治术后患者免疫功能和营养状况的改善情况.方法 选取我院2013年1月至2015年12月间收治的120例胃癌根治术患者,按随机数字表法分为实验组(n=60)与对照组(n=60).对照组采用肠外营养支持,实验组采用早期肠内营养支持.比较两组患者治疗后的免疫功能以及营养状况的改善情况.结果 两组患者术后第1天各免疫细胞(CD3+、CD4+、CD4+/CD8+和NK)的活性均较术前减弱(P<0.05).术后第7天实验组患者各免疫细胞的活性与术前水平相近(P>0.05),对照组明显低于术前水平和实验组(P<0.05).实验组患者术后的发热时间、肠功能恢复时间、排气时间以及住院时间均显著短于对照组(P<0.05).术后第1天两组患者白蛋白及前白蛋白含量分别为(25.2±5.8)g/L、(136.7±18.8)g/L和(25.5±6.0)g/L、(134.3±17.7)g/L,均较术前明显下降;实验组术后第7天前白蛋白及白蛋白含量分别为(172.5±22.8)g/L、(37.6±7.7)g/L,均显著高于对照组[(145.5±20.5)g/L、(31.3±7.5)g/L],差异具有统计学意义(P<0.05).实验组的并发症发生率为11.7%,显著低于对照组的28.3%,差异有统计学意义(P<0.05).结论 早期肠内营养治疗能够有效提高胃癌根治术患者的营养状况和免疫功能,值得在临床上推广.
展开▼
