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目的研究不同营养途径对胃癌手术后病人营养、免疫及炎症反应的影响。方法将96例胃癌病人随机分为肠外营养(PN组,n=7)和PN+肠内营养(EN组,n=7)。分别于术后第2~8天给予等氮、等热量的营养支持。于手术前1天、术后第1天和第9天分别检测总蛋白、清蛋白、前清蛋白、转铁蛋白、IgG、IgM、IgA、CD4、CD8、CD4/CD8、IL-1α、IL-2、IL-6、IL-10、TNF-α等项目,用药期间留24h尿,粪测定氮,计算氮平衡。结果研究结束时EN组前清蛋白、IgA、CD4、CD4/CD8均显著高于PN组,IL-6、TNF-α显著低于PN组。结论肠内免疫营养可减轻胃癌病人手术后机体炎症反应,改善免疫功能。
Objective To study the effects of different nutrition approaches on the nutrition, immune and inflammatory response of gastric cancer patients after operation. Methods Ninety-six gastric cancer patients were randomly divided into parenteral nutrition group (PN group, n = 7) and PN + enteral nutrition group (n = 7). Respectively 2 to 8 days after giving equal nitrogen, the calorie-like nutritional support. Total protein, albumin, prealbumin, transferrin, IgG, IgM, IgA, CD4, CD8, CD4 / CD8, IL-1α, IL were detected on the first day, the first day and the ninth day after operation -2, IL-6, IL-10, TNF-α and other items, stay 24h urine during the medication, fecal determination of nitrogen, calculate the nitrogen balance. Results At the end of the study, the levels of albumin, IgA, CD4 and CD4 / CD8 in EN group were significantly higher than those in PN group. The levels of IL-6 and TNF-α in EN group were significantly lower than those in PN group. Conclusion Enteral nutrition can relieve the inflammatory reaction and improve the immune function of gastric cancer patients after operation.