Clinical Research On Postoperative Early Enteral Immunonutrition United Parenteral Nutrition In The Advanced Gastric Cancer Patients

Objective To observe the effect of postoperative early enteralimmunonutrition united parenteral nutrition on nutritional status and immunefunction in advanced gastric cancer patients．Methods Seventy-five advanced gastric cancer patients were selected andrandomly divided into immune-enhancing enteral united parenteral nutritiongroup(IEPN,n=25)、 enteral united parenteral nutrition group(EPN,n=25)andparenteral nutrition group(PN,n=25).Patients of IEPN were given theimmune-enhancing enteral nutrient(TPF-T,400ml) and parenteral nutrition(KabivenTM PI,1440ml)from the postoperative2nd day to the8th day. Patients ofEPN were given the enteral nutrient(TP,500ml)and parenteral nutrition(KabivenTM PI,1440ml). Patients of PN were given parenteral nutrition(KabivenTM PI,1920ml). The levels of nutrition status(ALB,PA,TP)， immunefunction(CD3,CD4,CD8,IgA,IgM,IgG),and stress status(C3,C4,CRP)were detectedbefore operation and on postoprative8thday． The anastomotic fistula and bowelfunction were observed．Results On the8th day after operation,there was no statistic differencebetween each group on the serum levels of ALB、 PA、 TP (P>0.05); there was nostatistic difference between each group on the serum levels of IgM (P>0.05),theserum levels of IgA and CD3in IEPN group were significantly higher than thosein EPN group and PN group(P<0.05、 P<0.01),the ratio of CD4／CD8in IEPNgroup were significantly higher than that in EPN group and PN group(P<0.01、 P<0.01), the serum levels of IgG and CD4in IEPN group were significantly higherthan those in PN group (P<0.01),the serum levels of CD8in IEPN group weresignificantly lower than that in EPN group and PN group(P<0.05、 P<0.01); therewas no statistic difference between each group on the serum levels of C4(P>0．05)， the serum levels of C3in IEPN group were significantly higher thanthose in PN group(P<0.01), the serum levels of CRP in IEPN group weresignificantly lower than that in PN group (P<0.01); recovery time of postoperativebowel function in IEPN group was significantly shorter than PN group(P<0．05)，there was no anastomotic fistula in each group.Conclusions The application of postoperative early IEPN can maintainnormal nutrition status， enhance immune function， lower systemic inflammatoryreaction and accelerate the restoration of bowel functionin in patients withadvanced gastric cancer．...