术前与术后早期肠内营养对老年胃癌患者术后免疫功能及营养状态的影响

摘要

Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). No differences in the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were found between the two groups (P>0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.%目的：探讨术前1周及术后早期应用肠内营养制剂对老年胃癌患者术后免疫功能及营养状态的影响。方法：选取2011年3月至2014年3月在本院行手术治疗的77例老年胃癌患者，其中38例于术前1周及术后早期给予肠内营养制剂，并标记为实验组；其余39例患者术前1周及术后早期不给予肠内营养支持，并标记为对照组。统计分析两组患者术前、术后第1、8d前白蛋白、白蛋白、转铁蛋白、CD4+T细胞、CD8+T细胞比例、CD4+T细胞/CD8+T细胞（CD4+/CD8+）水平。结果：营养状态方面，术后1d两组患者前白蛋白、白蛋白及转铁蛋白水平均明显下降，且对照组下降程度大于实验组（P<0.05）。免疫功能方面，两组患者CD4+T细胞（%）、CD8+T细胞（%）、CD4+/CD8+水平术后1d均较术前减少，且对照组下降程度大于实验组（P<0.05）。结论：术前1周及术后早期给予老年胃癌患者适当的肠内营养支持，能使患者术后具有更好的免疫功能及营养状况，更有利于患者术后恢复。