| BackgroundThe incidence and mortality of gastric cancer is increasing year by year,ranking second in the mortality rate of malignant tumors in China,early onset of gastric cancer is not easy to diagnose,most patients were diagnosed,has been developed to the advanced stage.Gastric cancer itself caused by gastrointestinal barrier and absorption of functional damage,leading to significantly reduce the absorption of nutrients in patients with gastric cancer,malnutrition further exacerbated the situation,thereby inhibiting the immune function of patients,leading to radical gastrectomy after gastrectomy Complications of high incidence,seriously affecting the prognosis of patients.Early supplementation of nutrients and enhance immune function in patients is an important way to reduce postoperative complications and improve the prognosis of patients.ObjectiveTo explore the advantages and disadvantages of early immunization of enteral nutrition preparations and common enteral nutrition preparations in patients with radical gastrectomy.Through the observation of the two groups of patients with nutritional indicators,immune indicators and the incidence of complications and comparison,for clinical nutritional support to provide clinical basis,and then radical gastrectomy early nutrition support technology to further improve.MethodsThe clinical data of 76 patients with radical gastrectomy who underwent radical gastrectomy from January 2013 to December 2015 were retrospectively analyzed.The first day after operation was infused from the jejunum nasal feeding tube(Group A),a total of 37 cases;from the jejunum nasal feeding tube infusion of immunosuppressive enteral nutrition formulations Ruijin(B group),a total of 39 cases.All patients were treated with routine symptomatic treatment,and the clinical data such as anal exhaust time,hospitalization time,nutritional index,immunoglobulin,T lymphocyte and postoperative complications were collected and analyzed.There were no significant differences between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).Conclusion:There is no significant difference between the two groups in terms of age,sex and lesion location and clinical stage of gastric cancer.Results1.The postoperative anal exhaust time was 59.35±7.10 hours in group A,49.21± 7.61 hours after operation in group B,postoperative anal exhaust time was shorter than group A,and the statistical method was t test.The difference was statistically significant(P<0.05).At the same time,the hospitalization time of group A was 19.86±3.04 days,the hospitalization time of group B was 11.46±2.26 days,shorter than the hospitalization time of group A,and the difference was statistically significant(P<0.05).2.0n the 7th day after operation,33.89±2.47g/L of albumin in group A was 32.08±2.36g/L,and the difference was not statistically significant(P>0.05).On the 7th day after operation,the total protein of group A was 60.98±3.95g/L,the prealbumin 255.84±8.2mg/L and the transferrin 2.51±0.38g/L were higher than the total protein before operation 57.86±3.95g/L Albumin 189.34±6.1mg/L and transferrin 2.24±0.48g/L,the statistical method using t test,the difference was statistically significant(P<0.05).On the 7th day after operation,the total protein of group B was 63.55±4.64g/L,the prealbumin was 272.5± 10.2mg/L and the transferrin was 2.80±0.42g/L higher than the total protein before operation was 56.94±4.43g/L Albumin 190.29±6.6mg/L and transferrin 2.29±0.53g/L,the statistical method using t test,the difference was statistically significant(P<0.05).On day 7 postoperatively,the total protein of group B was 63.55±4.64g/L,albumin 35.75±2.74g/L,prealbumin 272.5±10.2mg/L and transferrin 2.80±0.42g/L were higher than A The total protein 57.86±3.95g/L,albumin 32.08±2.36g/L,pre-albumin 189.34±6.lmg/L and transferrin 2.24±0.48g/L,the statistical method using t test,the difference was statistically significant(All P<0.05).3.Immunoglobulin,the first 7 days after surgery,A group of immunoglobulin lgA2.36±0.74g/L,lgG10.44±2.2g/L and lgM1.18±0.35g/L were higher than preoperative immunoglobulin LgA2.08±0.65g/L,lgG9.581±2.73g/L and lgMO.95±0.33g/L,the statistical method using t test,the difference was statistically significant(P<0.05).On the 7th day after operation,the immunoglobulin lgA2.69±0.62g/L,lgG13.47±2.72g/L and lgM1.31±0.41g/L were higher than the preoperative immunoglobulin lgA2.02±0.57 g/L,1gG10.24±2.61g/L and lgM0.91±0.37g/L,the statistical method using t test,the difference was statistically significant(P<0.05).The immunoglobulin lgA2.69±0.62g/L,lgG13.47±2.72g/L and lgM1.31±0.41g/L in group B were higher than those in group A immunoglobulin lgA2.36±0.74 g/L,lgG10.44±2.2g/L and lgM1.18±0.35g/L,the statistical method using t test,the difference was statistically significant(P<0.05).4.The number of CD8+T cells in group A was 20.43±3.09%compared with 20.1±2.31%of preoperative CD8+T cells.The difference was not statistically significant(P>0.05).The number of CD8+T cells in group B was 21.17±3.52%and that of CD8+T cells was 19.62±2.6%after operation.There was no significant difference between the two groups(P>0.05)There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).Conclusion:The expression of CD8+T cells in group A was significantly higher than that in group B The number of CD4+T cells in group A was 36.85±3.83%higher than that in preoperative CD4+T cells(33.56±3.7%).The difference was statistically significant(P<0.05)The number of CD4+T cells in day B group was 42.43±5.73%higher than that in preoperative CD4+T cells(32.4±4.33%),and the difference was statistically significant(P<0.05).+ T cells was 42.93±5.73%higher than that of group A CD4+T cells 36.85±3.83%,the statistical method using t test,the difference was statistically significant(P<0.05).5.The occurrence of postoperative complication was 3 cases with wound infection,2 cases with pulmonary infection and 1 cases with anastomotic fistula in the control group;and 2 cases,1 cases and lcases in the experimenta 2 group,respectively.There was no significant difference between two groups of adverse reaction.ConclusionsPatients with early-stage Immune-enhancement enteral nutrition Supportan(group B)compared with early postoperative total gastrectomy were compared with those with early postoperative enteral preparations Short-Peptide Enteral Nutrition(group A):1.Can significantly shorten the time of anal exhaust,reduce hospital stay.2.More significantly improve the nutritional status of patients,improve serum levels of serum immunoglobulin,lymphocyte content,thereby improving the immune function of patients. |
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