目的 探究术后肠内营养联合肠外营养治疗对结直肠癌患者免疫功能及肠道菌群的影响。 方法 选取河北北方学 院附属第一医院 2019 年 1 月至 2021 年 5 月收治的结直肠癌手术治疗患者 90 例,使用随机数字表法将所有患者分为对照组 和研究组,每组 45 例,对照组给予肠外营养干预,研究组给予肠内营养联合肠外营养干预。 比较两组患者干预前后营养状况、 CD 细胞、免疫蛋白、肠道菌群水平和临床指标。 结果 干预前,两组血清总蛋白(TP)、血清白蛋白(ALB)、转铁蛋白(Tf)、血红 蛋白(Hb)和体质指数(BMI)水平差异无统计学意义(P>0. 05);干预后,研究组 TP、ALB、Tf、Hb 和 BMI 水平显著高于对照组 (P<0. 05)。 干预前,两组 CD3 + 、CD4 +和 CD4 + / CD8 +水平差异无统计学意义(P>0. 05);干预后,研究组 CD3 + 、CD4 +和 CD4 + / CD8 +水平显著高于对照组(P<0. 05)。 干预前,两组 IgA、IgG 和 IgM 水平差异无统计学意义(P>0. 05);干预后,研究组 IgA、 IgG 和 IgM 水平显著高于对照组(P<0. 05)。 干预前,两组乳杆菌、拟杆菌、真杆菌、双歧杆菌、球杆菌和大肠埃希菌数量的差 异无统计学意义(P>0. 05);干预后,研究组乳杆菌、拟杆菌和双歧杆菌数量显著高于对照组,球杆菌和大肠埃希菌数量显著低 于对照组(P<0. 05)。 研究组开始进食、肛门排气时间和住院时间显著低于对照组(P<0. 05)。 结论 肠内营养联合肠外营养 治疗能有效提高患者细胞免疫和体液免疫功能,调节患者肠道菌群,改善结直肠癌患者临床指标,促进患者术后恢复。

Objective To investigate the effect of postoperative parenteral and parenteral nutritional support on immunity and intestinal flora in patients with colorectal cancer. Method A total of 90 patients with colorectal cancer who were treated in the First Affiliated Hospital of Hebei Northern University from January 2019 to May 2021 were selected. All patients were divided into a control group and a research group by random number table method with 45 cases in each group. The control group was given parenteral nutrition intervention and the research group was given enteral nutrition combined with parenteral nutrition intervention. The nutritional status CD cells immune proteins intestinal flora levels and clinical indicators before and after intervention were compared between the two groups. Result There was no significant difference in the levels of serum total protein TP serum albumin ALB transferrin Tf hemoglobin Hb and body mass index BMI between the two groups before the intervention P>0. 05 after the intervention the levels of TP ALB Tf Hb and BMI in the research group were significantly higher than those in the control group P<0. 05 . The levels of CD3 + CD4 + and CD4 + / CD8 + in the two groups before intervention were not significantly different P>0. 05 the levels of CD3 + CD4 + and CD4 + / CD8 + in the research group after the intervention were significantly higher than those in the control group P< 0. 05 . There was no significant difference in the levels of IgA IgG and IgM between the two groups before the intervention P> 0. 05 after the intervention the levels of IgA IgG and IgM in the research group were significantly higher than those in the control group P<0. 05 . There was no significant difference in the number of Lactobacillus Bacteroides Eubacterium Bifidobacterium Coccobacillus and Escherichia coli between the two groups before the intervention P>0. 05 after the intervention the number of Lactobacillus Bacteroides and Bifidobacterium in the research group was significantly higher than that in the control group and the number of Coccobacillus and Escherichia coli was significantly lower than that in the control group P<0. 05 . The eating time anal exhaust time and hospitalization time of the research group were significantly lower than those of the control group P<0. 05 . Conclusion Enteral nutrition combined with parenteral nutrition support can effectively improve the cellular and humoral immune function of the colorectal cancer patients regulate the intestinal flora improve the clinical indicators and promote the postoperative recovery of the patients.