The Effect Of Smoflipid On Postoperative Recovery In Elderly Patients With Gastrointestinal Cancer

Objective: Patients who suffered from gastrointestinal tumor surgery are in a state of severe stress,it will cause varying degrees of inflammation and immune dysfunction.At this point,rational application of parenteral nutrition support therapy is of great significance for the improvement of postoperative body function and postoperative recovery.The fat milk as an important component of parenteral nutrition,so the choice of fat milk is of great important.The purpose of this study is to investigate the effect of SMOFlipid on postoperative immune function,nutritional status and inflammatory reaction of patients with gastrointestinal tumor.Methods: There are 55 patients with gastrointestinal tumor resection and all of them need for parenteral nutrition support at least 5 days,according to the randomized,control principles.they were randomly divided into two groups-study group(n=27)and control group(n=28).The first day after surgery,glucose was given as the main energy source of parenteral nutrition,and half of the required basic energy was supplemented with glucose.Starting from the second day on,the parenteral nutrition support which is isonitrogen0.2g/(kg.d)and isocaloric 104.6 k J/(kg.d),which uses glucose and fat milk as the main sources of energy,became the main energy support lasts 5 days,the control group was treated with Lipovenoes MCT 1.2g/(kg.d);the study group was received SMOFlipid1.2g/(kg.d).Preoperative and postoperative 1,6 days,fasting blood samples were collected from two groups of patients to detect the inflammatory index: white blood cell(WBC),C reactive protein(CRP);the nutrition indicators: total protein(TP),albumin(ALB);the liver and kidney function: alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),urea nitrogen(BUN)and the immune index:total lymphocyte count(TLC),lymphocyte subsets(CD3+,CD4+,CD8+,CD19+),immunoglobulins(Ig A,Ig G,Ig M,Ig E).The data of two groups were analyzed by SPSS19 statistical software.Results: To compared with the immune index,inflammatory indicators and nutritional indicators in the two groups,the following results can be obtained.There was a significant difference in the preoperative and postoperative of the immune index:CD3+,CD4+,CD8+,CD19+,Ig A,Ig M,Ig G,TLC;the nutritional index: TP,ALB;the liver and kidney function: ALT,AST,BUN,Cr and the inflammatory index : WBC,CRP(p<0.05).There was an interaction effect between time and group in CD19+,Ig G,TLC,TP(p<0.05).There was no significant difference between the two groups in preoperative and postoperative 1 day.6 days after surgery,the levels of CD3+,CD4+,Ig G,Ig A,TP were obviously improved in study group(p<0.05),and the inflammatory index CRP and WBC were significantly lower than those in control group(p<0.05).Conclusions: To concluded,patients who suffered from gastrointestinal cancer,benefit a lot from the parenteral nutrition support therapy,especially in postoperative recovery of immune function,improvement of inflammatory status and protection of liver and kidney function.The patients who are in the study group restored better than the control group.So,the elderly patients with gastrointestinal tumor who used SMOFlipid as parenteral nutrition support therapy,can significantly improve the postoperative immune state,inhibit the excessive inflammatory response and improve the body's immune function.