目的  观察免疫肠内营养对Siewert Ⅱ/Ⅲ型食管胃结合部腺癌患者接受不同重建方式后恢复、免疫功能、营养状况、 生存质量的影响。方法  将42 例 Siewert Ⅱ / Ⅲ型食管胃结合部腺癌患者随机分为 PG+ 空肠间置组和 TG 组，手术后均采取 免疫肠内营养治疗。检测术前1 天、术后5 天相关的营养和免疫血清指标，比较和分析术后恢复情况、生存质量和免 疫功能、营养状况。结果  PG+ 空肠间置组和 TG 组手术后肠道通气时间、术后 5 天体重变化、腹腔感染、吻合口瘘等并发 症的发生无显著差异。术后5 天检测PG+ 空肠间置组血清总蛋白、清蛋白、前清蛋白、IgG、IgA 水平以及CD3+、CD4+、 CD4+/CD8+ 与 TG 组比较，无显著差异（P ＞ 0.05）。术后12 个月PG+ 空肠间置组术后体重变化、血红蛋白较TG 组明 显改善（P ＜ 0.05）。PG+ 空肠间置组和 TG 组反流症状发生率均较低（P ＞ 0.05）。结论  早期使用免疫肠内营养，对比 Siewert Ⅱ / Ⅲ型食管胃结合部腺癌患者行PG+ 空肠间置术后和TG 术后的营养状况和免疫功能，证明PG+ 空肠间置组显优势。

Objective To compare the effects of enteral immunonutrition on recovery, nutritional status, immune function, quality of life in patients with Siewert II/III adenocarcinoma of esophagogastric junction received proximal gastrectomy plus jejunal interposition versus total gastrectomy. Methods 42 cases of Siewert II/III adenocarcinoma of esophagogastric junction patients were randomly divided into proximal gastrectomy plus jejunal interposition group (PG) and total gastrectomy group (TG). Postgastrectomy enteral immunonutrition therapy was early used in two groups. The changes of recovery, serum markers, nutritional status, immune function were evaluated on 1st day and 5th day postoperation. Quality of life were compared in 12 months postoperation. Results There were no significant difference neither in postoperative complications nor in levels of serum total protein, albumin, prealbumin and IgG, IgA, CD3+, CD4+, CD4+/CD8+ between 2 groups on the 5th day postoperation (P>0.05). The levels of weight loss and hemoglobin in PG+ jejunal interposition group was significantly increased (P<0.05) than TG group on 12 months after operation, no significant difference was seen in reflux symptoms between 2 groups. Conclusions Early usage of enteral immunonutrition in Siewert II/III adenocarcinoma of esophagogastric junction received PG+jejunal interposition can improve recovery, nutritional status and enhance immunity. PG+jejunal interposition was better than TG in postgastrectomy function reservation and life quality.