Effects of Nutritional Support on Nutritional Status and Immunal Function of Patients Following Surgery for Digestive Neoplasm of the Digestive Tract.

Objective: To evaluate the effects of enteral nutrition(EN) and parenteral nutrition(PN) on nutritional status and immune function of patients following surgery for tumors of the digestive tract. Methods: Fourty patients operated for tumor of the alimentary tract were divided into EN+PN group (n=20) and PN group (n=20). Isocaloric and isonitrogenous nutritional support was performed from the first day after the operation and was maintained for one week. Parameters of nutritional and immunal statuses were measured before and after nutritional support. Results: Body weight decreased significantly in both groups, but without significant difference. The plasma albumin concentration decreased significantly after surgery in two groups and more significantly in PN group (P0.05). The accumulated nitrogen balance is -26.1±15.3g in EN+PN group, and -23.4±10.3g in PN group, but without significant difference. Levels of CD 3,CD 4, CRP and IgM after nutritional support were higher in EN+PN group than those before the treatment. In PN group, the level of NK cells decreased significantly. Conclusions: In the status of stress in patients after surgery, neither EN nor PN can avoid catabolism. While producing similar effects on nitrogen balance, EN is superior to PN in terms of maintaining plasma albumin. EN could improve T-helper cell function and PN may lower the level of NK cell. Early EN after surgery is safe, feasible and effective.