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目的：观察对比老年消化道肿瘤患者术后给予肠内营养（EN）、肠外营养（PN）联合应用(EN+PN)和单独采用PN 对患者营养和免疫状况的影响。方法：选择我院2010 年6 月~2014 年10 月收治的老年消化道肿瘤患者60 例，采用随机数字表法将所有患者分为PN组27例和PN+EN 组33 例。检测并比较两组患者血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PreAlb)、转铁蛋白(TFN )、T 淋巴细胞亚群及体重（BW）指标及术后并发症。结果：术后第8 天较术前第七天两组患者血清Alb、PreAlb、TFN 均出现明显上升(P<0.05)，但两组间比较差异无统计学意义(P>0.05)，两组患者Hb 和BW 均略有下降，差异不存在统计学意义(P>0.05)；术后第 8 天EN+PN 组患者的CD3+、CD4+/CD8+基本恢复到第七天水平，而PN组患者CD3+、CD4+/CD8+均低于第七天水平，差异存在统计学意义(P<0.05)；术后En+PN 组较PN 组，肛门排气时间较早、住院时间较短，差异均存在统计学意义（P<0.05）；两组均未发现严重并发症。结论：PN+EN和PN 营养支持均可以改善老年消化道肿瘤患者术后的营养状况，但PN+EN 更有利于提高患者免疫力，缩短住院时间。因此，PN+EN 具有营养丰富、安全可靠的优点，值得临床推广应用。

英文摘要:

Objective:To compare the influence of enteral nutrition combined with parenteral nutrition(EN plus PN) and parenteral nutrition (PN) on postoperative nutrition and immune of elderly patients with digestive tract tumour.Methods:A total of 60 patients with digestive tract tumour, admitted to Fushun Hospital of Traditional Chinese Medicine fromJune 2010 to October 2014, were selected and randomly divided into PN group(n=27) and PN plus EN group(n=33). Then the hemoglobin(Hb), serum albumin(Alb), prealbumin (PreAlb), transferrin (TFN), T-lymphocyte subsets, body weight (BW) and postoperative complications of the two groups were detected and compared.Results:Serum Alb, PreAlb and TFN of the two groups 8d after operation were significantly increased compared with those of 7 d before operation (P<0.05), but there was no significant difference between the two groups (P>0.05); Hb and BWof the two groups, slightly decreased, the difference was not statistical significant(P>0.05); CD3+, CD4+ /CD8+ of the PN plus EN group 8 d after operation basically recovered to the levels of 7d before operation, while those of the PN group was significantly lower than the levels of 7d before operation (P<0.05), the difference was statistical significant (P<0.05); The postoperative anal exhaust time of PN plus EN group was earlier than that of PN group, and the hospitalization time of PN plus EN group was shorter than that of PN group, the differences were statistically significant (P<0.05). No serious complications were found in the two groups.Conclusion:Both PN plus EN and PN can improve the postoperative nutritional status of elderly patients with digestive tract tumour. However, PN plus EN is more helpful in improving the immunity of the patients,with the advantages of shortening hospitalization time, rich nutrition, safe and reliable, which is worthy of clinical application.

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