| 摘要: |
| 目的 比较胃癌全胃切除患者围术期两种免疫营养支持治疗的效果。方法 将接受全胃切除的胃癌患者随机分为围术期免疫营养（PIN）组60例，术前5d 给予肠外免疫营养支持治疗，术后早期给予肠内免疫营养支持治疗1 周；术后早期肠内免疫营养（EIN）组60例，仅在术后早期给予肠内免疫营养支持治疗1 周。比较两组患者术前及术后第1、7、10 天营养指标（总蛋白、白蛋白、前清蛋白、转铁蛋白、氮平衡）、免疫功能指标（IgG、IgA、IgM、CD3+、CD4+、CD4+/CD8+）的情况及术后感染性并发症（包括肺部感染、尿路感染、切口感染）的发生率。结果 PIN 组患者术前及术后第1天在提高患者营养指标，纠正免疫功能指标等方面较EIN 组有效，差异均有统计学意义（均P＜0.05），且PIN 组术后感染性并发症的发生率低于EIN 组（P＜0.05）。结论 胃癌全胃切除患者围术期应用免疫营养支持治疗较单纯术后早期应用，更能改善患者的营养状况，纠正免疫功能，减少术后并发症的发生。 |
| 关键词: 胃癌 全胃切除 免疫营养 围术期 |
| DOI： |
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| 基金项目:浙江省医学会临床科研资金项目 |
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| Perioperative immunonutrition for patients with gastric carcinoma undergoing total gastrectomy |
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XIE Qi, JIN Huicheng, JIA Zhong, JU Tongfa, SHAN Yuqiang
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Huzhou First People’s Hospital
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| Abstract: |
| Objective To investigate the clinic effect of perioperative immunonutrition(PIN) for patients with gastric carcinoma undergoing total gastrectomy. Methods One hundred and twenty patients with gastric carcinoma who underwent total gastrectomy during January 2012 and June 2014 in Hangzhou First People's Hospital were randomly divided into 2 groups: 60 patients in PIN group received parenteral immunonutrition support for 5d before operation and then enteral immunonutrition treatment for 1w after surgery; 60 patients in EIN (early enteral immunonutrition) group received enteral immunonutirtion treatment for 1w after surgery only. Nutrient status and immune function of these two groups were examined on the preoperative d1, postoperative d1, 7 and 10. The rate of postoperative infective complications were also documented. Results The indexes of nutrient status, immune function and nitrogen balance in PIN group were better than those in EIN group on preoperative d1 and postoperative d1(P＜0.05). The rate of postoperative infective complication in PIN group was lower than that in EIN group(P＜0.05). Conclusion Perioperative immunonutrition is safe and effective for patients with gastric carcinoma undergoing gastrectomy, with better nutritional status and immune function, and less postoperative infective complications. |
| Key words: Gastric carcinoma Total gastrectomy Immunonutrition Perioperative |
