Effects of early postoperative enteral nutrition in combination of micro-ecological feed preparations on intestinal flora and immune function in elderly colorectal cancer patients after surgery / 中华老年医学杂志

ABSTRACT

Objective:To investigate effects of early postoperative enteral nutrition in combination of micro-ecological feed preparations on intestinal flora and immune function in elderly colorectal cancer patients after surgery.Methods:Eighty-eight elderly colorectal cancer patients treated at our hospital from November 2017 to August 2019 were enrolled in the study.They were randomly divided into two groups(n=44, each) the observation group receiving micro-ecological feed preparations and enteral nutrition, and the control group receiving conventional parenteral nutrition.The intestinal flora index, cellular immune function, humoral immune function and complications were compared between the two groups.Results:There was no significant difference in the indices of intestinal flora between the two groups before operation(all P>0.05). In the control group, Bifidobacteria and Lactobacillus decreased, E. coli increased, and B/E value decreased after surgery compared with before surgery( P<0.05). In the observation group, Bifidobacteria and Lactobacillus decreased, E. coli increased and B/E value decreased after surgery compared with before surgery( P<0.05). Compared with the control group, the observation group showed that Bifidobacteria and Lactobacillus increased, E. coli decreased and B/E value increased after surgery( P<0.05). Serum inflammatory factors had no statistically significance difference between the two groups before operation( P>0.05). Levels of interleukin-6, C-reactive protein and tumor necrosis factor-α were increased in the two groups after surgery compared with before surgery( P<0.05), and the indexes were lower in the observation group than in the control group( t=4.841, 7.247 and 4.231, all P=0.000). Levels of IgG, IgM, IgA, CD3 + , CD4 + , CD8 + and the ratio of CD4 + and CD8 + were higher in the observation group than in the control group[(12.53±1.84) g/L vs.(11.47±1.92)g/L, (1.45±0.22) g/L vs.(1.33±0.17) g/L, (2.28±0.24) g/L vs.(2.13±0.12) g/L, (52.84±4.12)% vs.(50.43±3.91)% , (34.53±3.51)% vs.(30.75±3.62)%, (19.09±2.41)% vs.(18.24±0.53)% and (1.68±0.22)% vs.(1.43±0.15)%, t=2.644, 2.863, 3.120, 2.814, 4.973, 2.285 and 6.228, P=0.010, 0.005, 0.003, 0.006, 0.000, 0.025 and 0.000]. Conclusions:Early micro-ecological feed preparation in combination of enteral nutrition can improve the surgical effect and quality of life and promote disease recovery with a safety in patients with colorectal cancer.