目的探讨早期肠内免疫营养治疗对胃肠癌患者术后的临床疗效及其预后的影响。方法选取2015年1月至2018年12月惠州市第六人民医院收治的胃肠癌术后患者80例，按照随机数字法分为试验组和对照组，各组患者40例，试验组患者行早期肠内免疫营养治疗，对照组患者行全肠外营养治疗，观察两组患者的临床疗效，包括血清总蛋白（TP）、血清前白蛋白（PA）、白蛋白（ALB）、转铁蛋白（TF）等营养状态，体液免疫指标（IgM、IgA、IgG）和细胞免疫指标（CD3+T细胞、CD4+T细胞、CD8+T细胞）等免疫功能及对胃肠功能的影响。随访1年比较两组患者的术后胃肠道并发症预后情况。结果术后行早期免疫肠内营养治疗后，试验组的TP、PA、ALB、TF水平，IgM、IgA、IgG水平，CD3+T细胞、CD4+T细胞明显高于治疗前及对照组，CD8+T细胞明显低于治疗前和对照组，差异有统计学意义（P<0.05）；与对照组比较，试验组首次排气时间、首次排便时间、首次进食时间、肠鸣音恢复时间及住院时间明显缩短，差异有统计学意义（P<0.05）；试验组术后胃肠并发症发生率与对照组比较明显降低，差异有统计学意义（P<0.05）。结论胃肠癌术后患者早期行肠内免疫营养治疗临床疗效显著，能够改善营养状况、免疫功能，促进胃肠道功能恢复，降低胃肠道并发症的发生，有效改善患者预后。
Abstract
Objective To investigate the effect of early enteral immunonutritional nutrition (EIN) support therapy on postoperative clinical efficacy and prognosis of patients with gastrointestinal cancer. Methods Eighty postoperative patients with gastrointestinal cancer admitted to our hospital from January 2015 to December 2018 were randomly divided into the experimental group and the control group according to the random number method, with 40 patients in each group receiving early enteral nutrition support treatment in the experimental group and total parenteral nutrition support treatment in the control group, to observe the clinical efficacy of the two groups of patients, including serum total protein (TP), serum prealbumin (PA), albumin (ALB), transferrin (TF) and other nutritional status, humoral immune indicators (IgM, IgA, IgG and IgG) cellular immune indicators (CD3+, CD4+, CD8+) and other immune functions, gastrointestinal function, the prognosis of postoperative gastrointestinal complications in the two groups was compared after 1 year of follow-up. Results After early postoperative enteral immunonutritional nutrition treatment, TP, PA, ALB, TF levels, IgM, IgA, IgG levels, CD3+, CD4+ levels in the Experimental group were significantly higher than those before treatment and the control group, and CD8+ levels were significantly lower than those before treatment and the control group, with statistically significant differences (P<0.05). Compared with the control group, the experimental group’s first exhaust time, first defecation time, first feeding time, bowel sound recovery time and hospitalization time were significantly shortened (P<0.05)；the incidence of postoperative gastrointestinal complications in the experimental group was significantly lower than that in the control group, with statistically significant difference (P<0.05). Conclusion The clinical effect of early enteral immunonutritional nutrition support treatment after gastrointestinal cancer is significant, which can improve the nutritional status and immune function, promote the recovery of gastrointestinal function, reduce the occurrence of gastrointestinal complications, and effectively improve the prognosis of patients.
关键词
肠内免疫营养治疗 /
胃肠癌 /
临床疗效 /
预后研究
Key words
Enteral immunonutritional nutrition support therapy /
Gastrointestinal cancer /
Clinical efficacy /
Prognosis research
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