目的:探讨肠内、外营养饮食干预对胃癌根治术后恢复、营养状况及免疫功能的影响 。方法:选取我院收治的胃癌患者180例,随机分成对照组与观察组每组90例。对照组患者接受肠外营养干预,观察组患者接受肠内、外营养饮食干预。比较两组患者细胞免疫功能、体液免疫、营养状况、并发症发生情况。结果:干预前两组患者细胞免疫功能指标水平比较,差异无统计学意义(P>0.05)。干预后观察患者的CD3⁺、CD4⁺、CD4/CD8⁺显著高于对照组,CD8⁺显著低于对照组(P<0.05)。疗前两组患者IgM、IgA、IgG水平比较,差异无统计学意义(P>0.05)。治疗后两组IgM、IgA、IgG水平较治疗前低(P<0.05),观察组患者IgM、IgA、IgG水平显著低于对照组(P<0.05)。干预前两组白蛋白、前白蛋白水平比较,差异无统计学意义(P>0.05)。干预后两组白蛋白、前白蛋白水平较治疗前升高,其中观察组白蛋白、前白蛋白水平显著高于对照组(P<0.05)。观察组并发症发生率显著低于对照组(P<0.05)。结论:肠内、外营养饮食干预能促进胃癌根治术后恢复,改善患者机体营养状况,提高患者机体免疫功能,预防并发症。

Objective: To explore the effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune function after radical operation of gastric cancer. Methods:A total of 180 patients with gastric cancer treated in our hospital from January 2016 to December 2017 were selected, and randomly divided into the control group and the observation group by computer, with 90 cases in each group. Patients in the control group received parenteral nutrition intervention, and patients in the observation group received enteral and parenteral nutritional diet intervention. Cellular immune function, humoral immune function, nutritional status, and complications occurrence situation in the patients were compared between the two groups. Results:There was no difference in the levels of cellular immune function between the two groups before intervention (P>0.05). After intervention, the CD3⁺, CD4⁺, CD4/CD8⁺ in the patients of the observation group were significantly higher than the control group, and CD8⁺ was significantly lower than the control group (P<0.05). There were no differences in IgM, IgA, and IgG levels between the two groups before treatment (P>0.05). The levels of IgM, IgA and IgG in the two groups were lower than those before treatment (P<0.05). The levels of IgM, IgA and IgG in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in albumin and prealbumin levels between the two groups before intervention (P>0.05). After intervention, the levels of albumin and prealbumin in the two groups were higher than those before treatment. The albumin and prealbumin levels in the observation group were significantly higher than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Enteral and parenteral nutritional diet intervention can promote the recovery after radical operation of gastric cancer, improve the nutritional status of patients, improve the immune function of patients, and prevent complications.

R735.2

首都医学发展科研基金(2015-2148)