【摘要】 目的 探讨食管癌患者围术期肠内营养治疗对营养状态、免疫功能、肠粘膜屏障的影响。方法 将128例进行手术治疗的食管癌患者按随机数字表法分为两组,每组64例,观察组围术期予以肠内营养治疗,对照组予以常规肠外营养治疗,观察7 d。治疗前后检测两组的营养指标(白蛋白、前白蛋白、转铁蛋白、血红蛋白)、体液免疫功能指标(IgA、IgG、IgM)、细胞免疫功能指标(CD4~+、CD8~+、CD4~+/CD8~+)和肠粘膜屏障指标(二胺氧化酶、肠脂肪酸结合蛋白、尿乳果糖/甘露醇)的变化。结果 肠内营养治疗后观察组白蛋白、前白蛋白、转铁蛋白、血红蛋白、IgA、IgG、IgM、CD4~+、CD8~+、CD4~+/CD8~+水平均显著高于对照组(P<0.05);治疗后观察组二胺氧化酶水平较治疗前显著升高,且显著高于对照组(P<0.05),肠脂肪酸结合蛋白、尿乳果糖/甘露醇水平较治疗前显著下降,且显著低于对照组(P<0.05)。结论 食管癌围术期肠内营养支持治疗可以有效改善患者的营养状态、增强免疫功能和肠粘膜屏障,值得推广应用。更多还原

【Abstract】 Objective To investigate the effects of perioperative enteral nutrition support on nutritional status, immune function and intestinal mucosal barrier in patients with esophageal cancer. Method 128 cases of esophageal cancer patients were randomly divided into two groups, 64 cases in each group. The observation group was given perioperative enteral nutrition support, and the control group was given routine parenteral nutrition treatment, patients were observed for 7 d. The changes of nutritional indexes [albumin(ALB), prealbumin(PA), transferrin(TRF) and hemoglobin(Hb)], humoral immune function indexes(IgA, IgG,IgM),cellular immune function indexes(CD4~+,CD8~+,CD4~+/CD8~+) and intestinal mucosal barrier markers [diamine oxidase(DAO), enteric fatty acid binding protein(IFABP), lactulose/mannitol(L/M)] of the two groups before and after treatment were compared. Results Levels of ALB, PA TRF,Hb,IgA,IgG,IgM,CD4~+,CD8~+,CD4~+/CD8~+ of the observation group after enteral nutrition support were significantly higher than those of the control group(P<0. 05); after treatment, DAO level of the observation group was significantly increased, and was significantly higher than that of the control group(P<0. 05), IFABP, L/M were significantly declined, and were significantly lower than those of the control group(P<0. 05). Conclusion Perioperative enteral nutrition support for esophageal cancer patients can improve the nutritional status, immune function and intestinal mucosal barrier function,which is worthy of wide application.更多还原