Early Enteral Nutrition In Gastric Cancer With Clinical Effects And Immune Correlation

Objective:To evaluate the relationship between early enteral nutrition and total parenteral nutrition in patients with accelerated gastric cancer and its clinical effects.Methods:Sixty patients who underwent distal gastric surgery in the Department of Gastrointestinal Surgery,First Hospital of Jilin University from June 2018 to January2019,were randomly divided into two groups.One group was early enteral nutrition + parenteral nutrition(EEN+PN),which was experimental group(n = 30cases)and the other group was total parenteral nutrition(TPN),which was control group(n = 30 cases).Patients,with gastric cancer who met the selection criteria of the experimental group,were given enteral nutrition and normal diet before operation,supported post-operatively by EEN+PN.The patients of gastric cancer in the control group received normal diet before operation and received TPN support after operation.All patients were confirmed by pathology and received distal gastrectomy.Clinical outcomes,including exhaust time,lymphocytes,albumin,IgG,IgM,IgA,C3,C4,CD4+,CD8+,CD3-CD56+ cell counts,and postoperative complications,were recorded and assessed.Result:The Alb of the patients in the EEN+PN and TPN group were respectively 39.67±4.29 g/L and 40.32±5.07 g/L,and there was no significant difference(P>0.05).On the first day after operation,the level of the Alb was 32.26±4.33g/L in the EEN+PN group and 29.77±4.90g/L in the TPN group.The Alb of the two groups was significantly lower than that before the operation,but the experimental group decreased slowly(P< 0.05),the Alb level of the two groups increased on the fourth day after operation,but the ascent of the experimental group was higher as compared to that of the control group(P<0.05).There were no significant differences in the counts of LYM,IgG,IgM,IgA,C3,C4,CD4+,CD8+,CD3-CD56+between the two groups(P>0.05).The immunity of all patients was significantly compromised at 1 day after surgery,but the EEN+PN group was less impaired than the TPN group(P<0.05).The level of LYM in the two groups decreased at 1 and 4days after surgery,but the level was lower in the EEN+PN group than the control group(P <0.05).The level of CD8+ in the EEN+PN and the TPN group increased at 1day after surgery,and decreased at 4 days,but the decrease in the EEN+PN group was lower,and the increase was larger.At 1 day after surgery,the level of IgG,IgM,IgA,CD4+,and CD3-CD56+ decreased in the two groups,but increased at 4 days and returned to the preoperative level.The EEN + PN group had a lower decrease than the TPN group.The increase of EEN + PN was significantly higher than that,and P<0.05 was comparable.The exhaust time of gastric cancer patients in EEN +PN group(49.14± 8.44)h was earlier than that in TPN group(64.03 ±10.74)h(P<0.05).The postoperative complicationsin of EEN + PN group(n=7)and TPN group(n=9),there was no statistical difference(P > 0.05),but the incidence of pneumonia in the EEN + PN group(n = 0)was significantly lower than that in the TPN group(n = 4),with a difference(P < 0.05).Conclusion:1.Early enteral nutrition and parenteral nutrition of gastric cancer is superiorto total intravenous nutrition in patients with gastric cancer.2.Early enteral nutrition and parenteral nutrition of gastric cancer can reduce postoperative complications and improve immunity.