低氮低热量肠外营养对胃癌患者全胃切除术后免疫功能的影响

摘要

Objective To investigate the impact of hypocaloric and hyponitrogenic parenteral nutrition(group HHPN) on immune function of gastric cancer patients after total gastrectomy.Methods Sixty-three patients with gastric cancer were randomly and equally assigned into two groups of total parenteral nutrition (group TPN) and HHPN (group HHPN) for parenteral nutrition.Peripheral blood lymphocyte count, IgG, IgM, IgA, CD4, CD8, CD4/CD8 and human leukocyte antigen (HLA)-DR were examined one day before, on the 1st and 8th day after operation. The infectious complication was recorded as well. Results Nutritional status of two groups showed no significant difference. The postoperative lymphocyte count and the expressions of IgG, CD4,CD4/CD8 and HLA-DR were significantly higher in group HHPN than those in group TPN(P＜0. 05). Postoperative infectious complication rate was lower in group HHPN than that in group TPN. Conclusion HHPN is better than TPN in promoting the recovery of postoperative immune function and reducing infectious complication in the patients with gastric cancer after total gastrectomy.%目的 探讨低氮、低热量肠外营养对全胃切除术患者术后早期免疫功能的影响.方法 将63例胃癌术后患者随机分为全胃肠外营养组(TPN,31例)和低氮、低热量肠外营养组(HHPN,32例)行肠外营养治疗.于术前1天、术后第1天和第8天分别检测外周血淋巴细胞计数、免疫球蛋白(IgC、IgM、IgA)、T淋巴细胞亚群(CD4、CD8、CD4/CD8)和人类白细胞抗原DR(HLA-DR)水平,比较两组的营养状况和免疫功能及术后感染性并发症等指标的差异.结果 两组营养状况情况相仿.与TPN组比较,HHPN组术后第8天淋巴细胞计数、IgG、CD4、CD4/CD8和HLA-DR的表达显著升高(P<0.05),术后感染性并发症低.结论 胃癌全胃切除术后使用低氮、低热胃肠外营养更有利于患者术后免疫功能的恢复和减少感染性并发症.