术前肠内营养对胃癌患者围手术期作用的研究

目的研究胃癌患者术前肠内营养支持对机体免疫功能的影响．方法选择择期手术的胃癌患者50例，随机分为两组，术前术后肠内营养组（观察组）；术后肠内营养组（对照组）．两组患者均从术后24h起自营养管给予等热量、等氮量的肠内营养剂．观察组于术前7d起口服能全力（纽迪西亚公司）500mL／d至术前1d．术前、术后第1，8天抽取静脉血，检测白蛋白、转铁蛋白、前白蛋白指标；外周血；T淋巴细胞．结果两组患者术后均有免疫功能的降低，但观察组比对照组术后第1，8天的CD4／CD8比值IgG水平显著增加；术后第8天的前蛋白浓度显著增加．结论胃癌患者围手术期（术前术后）使用肠内营养剂，可以有效改善患者的免疫功能．

Influence of Enteral Nutrition during the Perioperative Period on Postoperative Patients with Gastric Cancer

Objective To evaluate the influence of the enteral nutrition before operation on immunologic funetion in patients with gastric cancer. Method Fifty patients with gastric cancer were randomly divided into two groups： the group receiving enteral nutrition before and after operation （ observation group ）, and the group receiving postoperative enteral nutrition （ control group）. Two groups all received eternal nutrition within the first 24 hours after operation, observation group was given eternal nutritional support （NUTRICIA corp） 500 mL/d and maintained for 7 days. Takeing peripheral blood on the first and the eighth preoperative and postoperative days, and inspecting Albumin, transferrin, prealbumin, T lymphocyte levels . Results The immune function of patients in two groups were reduced, but the ratio of CD4/CD8 and IgG level were significantly increased in observation group than those in control group on the first postoperative day . The ratio of CD4/CD8 and IgG and proalbumin levels were significantly increased in observation group than those in control group on the eighth postoperative day . Conclusion The nutritional support of enteral nutrition during the perioperative period can improve the immunologic status of patients with gastric cancer patient after the surgery.