早期肠内营养对结直肠癌术后机体免疫、早期康复及并发症的影响

摘要

目的：比较早期肠内营养(EEN)与肠外营养(EPN)对结直肠癌术后患者机体免疫功能、早期康复及并发症的影响。方法：选择200例结直肠癌根治术患者，按照数字列表法随机分为观察组与对照组各100例，观察组术后给予早期肠内营养，对照组给予早期肠外营养，比较两组患者免疫学指标、平均肛门排气时间、下床时间、住院时间及并发症情况。结果：①营养支持后观察组IgG、IgA、IgM水平，CD3、CD4百分比均较对照组显著增高，CD8百分比与CD4/CD8比值降低显著，差异有统计学意义（P<0.05）；②观察组患者术后排气时间、下床时间、住院时间显著短于对照组，两组比较差异有统计学意义（t1=21.445，t2=27.186，t3=19.187，P<0.05）；③观察组术后并发症发生率为3%，明显低于对照组的15%，比较差异有统计学意义（χ2=19.762，P<0.05）。结论：早期肠内营养支持可提高患者机体免疫功能，促进早期康复，预防术后感染。%Objective: To Compare the effects of early enteral nutrition (EEN) and total parenteral nutrition (EPN) on immune function, early rehabilitationand and complications after colorectal cancer surgery.Methods: 200 cases of colorectal cancer patients with radical surgery were enrolled and randomly divided into observation group (n=100) and control group (n=100) according to the digital list method. After surgery, the observation group were given early enteral nutrition and the control group were given early parenteral nutrition The indexes of two groups were compared including immunology index, the average time of flatus, bed time, hospital stay and complications.Results:①IgG, IgA, IgM levels, CD3, CD4 percentage of the observation group were significantly higher than those of the control group, CD8 percentage and CD4 / CD8 ratio decreased significantly in the observation group, the difference was statistically significant(P<0.05);②Exhaust time, bed time, hospital stay of the observation group was significantly shorter than that of the control group after surgery, the difference was also statistically significant,t1=21.445,t2=27.186,t3=19.187, P<0.05);③ The complication rate of the observation group (3%) was significantly lower than that of the control group (15%) , and the difference was statistically significant (χ2=19.762,P<0.05).Conclusion: Early enteral nutrition can improve immune function in colorectal cancer patients after surgery,promote early rehabilitation, and prevention of postoperative infection.