Effect Of Perioperative Enteral Nutrition On The Immune Function In Patients With Gastrointestinal Carcinoma

Objective:To investigate the effect of perioperative enteral nutrition(EN) and the effect of perioperative parenteral nutrition(PN) on the immune function in patients with gastrointestinal carcinoma. Methods:46 patients were randomly divided into the EN group(n=22) and the PN group(n=24). Patients in EN group were given EN 5 days preoperative and 7 days postoperative. Patients in PN group were given PN in the same time. Immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement C₃(C₃), complement C₄(C₄), C-reactive protein(CRP), lymphocyte magnitude(LYM), LYM%, total protein(TP), albumin(ALB) and prealbumin(PA) in all patients were observed. The recovery time of gastrointestinal function postoperative and the costs of nutrition and hospitalization were recorded. Results:Comparing with data at one day preoperative, IgA, IgG, C₃, LYM, LYM% and PA decreased at one day postoperative and increased at eight day postoperative. The rising extend of data in EN group(0.926±0.468g/L ,6.011±3.179g/L,0.754±0.465g/L,1.178±0.581×10⁹/L,18.685%±14.331%,63.875±32.436mg/L) was higher than that in PN group (0.081±0.527g/L,0.440±3.363g/L,0.093±0.449g/L, 0.293±0.176×10⁹/L,4.443%±5.724%,34.571±31.701mg/L)(P<0.05/0.01). The different nutrition way played a significant part in these changes(P<0.05). The recovery time of gastrointestinal function postoperative in EN group(40.5±13.51h) was shorter than that in PN group(69±18.7h)(P<0.01). The costs of nutrition and hospitalization in EN group($5541.1±546.8, $20353.7±4733.4) were remarkably cheaper than that in PN group($7803.2±1072.9, $26344.2±7571.3)(P<0.01). Conclusions:During the perioperative period, EN can retrieve cacotrophy, improve immune function, facilitate gastrointestinal recovery and save cost of hospitalizition.