中文摘要：

目的探讨早期肠内免疫营养对经腹会阴联合直肠癌根治术后患者免疫功能、炎症反应的影响。方法将112例行经腹会阴联合直肠癌根治术的患者随机分为两组,观察组（56例）术后24 h开始使用免疫型肠内营养制剂瑞能;对照组（56例）术后使用常规的肠内营养制剂能全力。所有患者均于术前和术后第1、8天分别检测免疫指标和炎症反应指标：1CD3、CD4、CD8、CD4/CD8、NK细胞、IgA、IgG、IgM;2CRP、TNF-α、PGE。观察术后人工肛门首次排气和排便时间、会阴部伤口愈合时间、并发症发生率及平均住院时间。结果术前与术后第1天,两组免疫指标与炎症反应指标比较,差异无统计学意义（P〉0.05）;术后第8天,观察组患者CD3、CD4、CD4/CD8、NK、Ig G、CRP、TNF-α及PGE水平,与对照组比较,差异有统计学意义（P〈0.05）。观察组术后人工肛门首次排气和排便时间、会阴部伤口愈合时间及平均住院时间均早于对照组（P〈0.05）;两组术后并发症发生率比较差异无统计学意义（P〉0.05）。结论经腹会阴直肠癌根治术后患者早期应用肠内免疫营养能改善机体免疫功能,抑制炎性反应,促进患者术后早期康复。

英文摘要：

Objective To evaluate the effect of early enteral immunonutrition on postoperative immune function and inflammatory response in people treated with abdominal perianal colorectal cancer resection. Methods 112 patients underwent abdominal perianal colorectal cancer resection were randomly assigned into 2 groups： the observation group（ 56 cases） treated with immune enhanced enteral nutrition 24 h later after surgery,and the control group（ 56 cases） treated with general enteral nutrition.CD3,CD4,CD8,CD4 / CD8,NK,Ig A,Ig G,Ig M,CRP,TNF-α and PGE were investigated in the preoperative and postoperative 1st,8th day. The time of the first artificial anal exhaust and defecation after operation,perineal wound healing,incidences of postoperative complications and the average duration of hospitalization were observed. Results The preoperative and the first day after operation,there was no statistically difference between the 2 groups in immune parameters and inflammation indicators（ P〉0. 05）;The 8th day after operation,CD3,CD4,CD4 / CD8,NK,IgG,CRP,TNF-α and PGE in the observation group and the control group had statistically significant difference（ P〈0. 05）. The time of the first artificial anus exhaust and defecation after operation,perineal wound healing and average duration of hospitalization in the observation group were earlier than those of the control group（ P〈0. 05）; There was no significant difference in the incidences of postoperative complications between the 2 groups（ P〉0. 05）.Conclusion Early enteral immunonutrition for patients who underwent abdominal perianal colorectal cancer resection can improve the organism immune function,inhibit the inflammatory response,and promote early postoperative rehabilitation.