The Correlation Analysis Of Early Enteral Nutrition Support And The Recovery Of Immune Homeostasis After Gastric Cancer Surgery

Objective:Investigate the correlation between early enteral nutrition and immunologic function recovery after gastric cancer surgery.Through the study of the C-reactive protein(CRP)and cellular and humoral immunologic function impacted by early enteral nutrition and total parenteral nutrition in patients with gastrectomy.,to provid the rationale of early enteral nutritional support for clinical treatment of gastric surgery.Methods:Collect 40 patients were diagnosed with gastric cancer in the People’s Hospital of Zhejiang Province,meetting the inclusion criteria,from April 2014 to October 2015.Then they were randomly divided into control and experimental groups with 20 cases each.Use a prospective randomized control study.Control group was treated to total parenteral nutrition,experimental groups to enteral nutrition,the two groups of patients herein are isocaloric and nitrogen nutritional support for 7 days.Outcomes included postoperative infections occurrence of the two groups of patients:statistics wound infection,drainage around the tube infections,abdominal infections and the incidence of pulmonary infection;the values of CRP complement C3 and C4,immunoglobulin A、M、G(IgA、IgG、IgM),T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+,which were measured on one day before surgery,and the first 1,3,7 days after surgery,by extracting from peripheral blood 10ml around 6 am in fasting state.Registered the data collected,and then used SPSS 17.0 statistical software to analysis,count data were expressed as apercentage and used chi-square test;measurement data were espressed as(average add or subtract standard deviation),the group comparison used independent samples t-test,and the comparison between groups used single-factor repeated measures analysis of variance data.When P was less than 0.05 which indicated that the statistically difference was significant,finally draw the relevant conclusions.Results:1.After gastric cancer surgery,the serum CRP levels of early enteral nutrition group were less than total parenteral nutrition group,and they also decreased faster after operation(p<0.05).2.Early enteral nutrition group postoperative infection rate was significantly lower than total parenteral nutrition group(p<0.05).3.Compared with the total parenteral nutrition group,the C3 of the early enteral nutrition group could rapidly recover after surgery(p<0.05),and it continued to rise within three days after surgery,and then gradually decreased.While the C4 levels of the two groups before and after the surgery changed little.4.The postoperative humoral and cellular immune function were in varying degrees of reduction of the two groups:the serum immunoglobulin levels,especially IgA levels,of the enteral nutrition group were stable before and after the operative;the serum immunoglobulin IgA levels of the other decreased obviously(p<0.05).The Serum IgG and IgM in two groups of patients have shown a rising trend after the first drop,the difference was not statistically significant.The recovery speed of serum CD3+and CD4+lymphocyte of the early enteral nutrition group was faster than the total parenteral nutrition group(p<0.05);While the serum CD8+ lymphocytes in the two groups before and after surgery changed little.Conclusions:After gastric cancer surgery,early enteral nutrition would help to restore immune function,reduce the incidence of postoperative infection and other complications.But the sample size is small,if you want clear whether early postoperative enteral nutrition impact immune function recovery,still need a larger sample and multi-center study.