目的:分析胆囊结石患者行微创保胆取石术后结石复发的情况及影响因素,评估保胆取石术的可行性.方法:收集2019年12月—2021年10月在我院接受保胆手术治疗的患者171例,进行为期1年的术后随访,分成13例复发组,158例未复发组.比较两组的性别、年龄、家族史、高血压、糖尿病、体质量指数(BMI)、结石数量、胆囊壁毛糙、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及服用中药情况,采用多因素Logistic回归分析结石复发的相关因素.结果:患者术后1年复发率为7.6％(13/171).两组结石数量、胆囊壁毛糙、TG、HDL-C、家族史、服用中药差异有统计学意义(P＜0.05).多因素Logistic回归分析显示:胆囊结石数量＞1 个(OR=11.585,95％CI=1.578～85.030,P=0.016)、TG水平高(OR=4.139,95％CI=1.402～12.220,P=0.010)、有胆囊结石家族史(OR=8.785,95％CI=1.238-62.345,P=0.030)是保胆术后结石复发的独立危险因素,服用中药(OR=0.059,95％CI=0.008-0.433,P=0.005)可以降低术后结石的复发率.结论:对于有强烈保胆意愿的患者,行保胆取石术是有效的,但有一定的复发风险,保胆取石术胆囊结石数量多、TG水平高、有家族史是保胆取石术后结石复发的独立危险因素,服用排石汤可降低复发风险,具有风险因素的患者应谨慎行保胆取石术,或术后针对危险因素进行预防性治疗.

根据国际恶性肿瘤研究机构统计全球每年新增确诊恶性肿瘤中胃恶性肿瘤占5.6％,位于第5位.胃恶性肿瘤的发病率在世界范围内存在显著差异[1].在过去20年中,在胃恶性肿瘤(GS)的治疗方法上有了显著的进步.对局部晚期疾病患者使用新辅助疗法,以及外科技术的不断发展和标准化,均有效改善患者的预后.但胃恶性肿瘤患者的长期生存率仍远低于其他恶性肿瘤[2].造成这些不良结果的原因无疑是多因素的,与其他肿瘤部位相比,胃恶性肿瘤患者存在局部晚期病灶或远处转移的概率更高.此外,手术切除在技术上具有挑战性,术后病死率仍然较高[3].在胃恶性肿瘤中,恶病质可能是影响术前评估、术后恢复以及非治愈性治疗方法疗效的一个关键因素.本文对恶病质病理生理学和胃恶性肿瘤治疗的相关性综述如下.

患者老年男性,因"右侧腹痛3 d"于2020年7月29日入院.3 d前出现右侧腹痛伴发热呕吐,门诊腹部CT发现阑尾增粗,周围脂肪间隙模糊;十二指肠降部肠壁可疑增厚.追问病史发现8年前有类似腹痛史,当时保守治疗.入院后查血常规:白细胞11.8×109/L,中性粒细胞比例87.8％,淋巴细胞8.2％;肿瘤标志物甲胎蛋白、癌胚抗原、CA19-9均正常.十二指肠镜发现降部约2.5 cm×3.0 cm充血隆起,质硬,中间凹陷.活检病理:黏膜慢性炎,局灶区呈腺瘤样增生,小灶腺上皮低级别上皮内瘤变.超声内镜提示降部黏膜隆起,外瘘? 病理:黏膜慢性炎伴局灶呈息肉样增生.8年前患者腹部CT发现急性化脓性阑尾炎,头端积脓.本次增强CT发现阑尾管壁增厚强化,周围脂肪间隙模糊,十二指肠降部肠壁增厚,增强后可见强化.初步诊断:慢性阑尾炎急性发作,阑尾十二指肠瘘? 十二指肠肿瘤? 完善术前准备后行腹腔镜探查,术中见阑尾根部位于距回盲部约2.5 cm处,体部经回盲部后方向上,头端紧邻十二指肠降部,并形成致密粘连(图1) ,沿阑尾浆膜层分离至十二指肠,证实为阑尾十二指肠外瘘,行阑尾切除术,同时切除瘘口及周围部分肠壁送术中冰冻,提示局灶腺上皮轻度非典型增生,未见明确恶性证据.术中与家属沟通后行十二指肠修补术.十二指肠降部肿物考虑系长期阑尾炎症刺激引起,多次病理均未发现恶性证据,因此术中并未切除整个肿物所在的肠壁,术后定期复查十二指肠镜.患者术后恢复良好,随访至今,未诉特殊不适.

Chemerin是脂肪组织和肝脏分泌的一种蛋白质,其与脂肪、血管生成,脂质以及葡萄糖代谢有关,chemerin是促进多种免疫细胞趋化的重要因素,并在几种病理生理过程中起重要作用.Chemerin受体存在于单核细胞/巨噬细胞、T细胞、自然杀伤细胞、树突细胞以及嗜中性粒细胞上,然而,有关chemerin和chemerin受体在消化道肿瘤中的病理生理作用研究较少.越来越多的临床和实验研究发现,在食道癌、胃癌、肝癌、大肠癌在内的许多疾病中,chemerin和chemerin受体受到了干扰.此外,chemerin和chemerin受体已被证明可调节免疫细胞以及与癌症相关的成纤维细胞的增殖、迁移和侵袭.本文重点介绍Chemerin在消化道肿瘤病理生理中的研究进展.

自发性食管破裂是一种罕见疾病,而在肠道准备过程中发生自发性食管破裂更是罕见.该病的死亡率很高,治疗原则是清除污染源,封闭裂口,恢复食管完整性,充分引流,控制感染,加强营养支持,改善身体状况,促进伤口愈合.但关键是避免患者在肠道准备过程中因剧烈呕吐而发生自发性食管破裂,笔者建议小口、多次服用导泻剂.

在大多数国家中,胃癌通常是在疾病的晚期被确诊的.我们总结了目前关于早期胃癌病变的诊断和治疗的科学证据,包括了对这些病变患者筛查、诊断、评估、治疗和随访等主题,并讨论了未来的研究领域. 1 诊断和评估 理论上,胃癌筛查可能会提高早期病变的确诊率,降低病死率.然而,目前仍不清楚何时进行筛查及应对谁进行筛查.尽管有几个因素和条件可能导致胃癌,如先前的胃部手术、胃癌家族史、自身免疫性胃炎、萎缩性/化生性胃炎、遗传和基因条件,但对于其中许多情况,尚未确定明确的筛查指征.

目的 研究二甲肼(DMH)诱导大鼠结肠癌模型的建立及其病理学特征、肠道菌群变化.方法 将70只3月龄Wistar大鼠随机均分为模型组、对照组,模型组经皮下注射DMH建立结肠癌大鼠模型,对照组大鼠注射同等剂量的生理盐水,对两组大鼠的病理学特征和肠道菌群变化进行观察.结果 DMH注射12周后,模型组中部分大鼠肛门处可见红肿溃破,结肠上皮结构异常,腺体和淋巴组织增生明显,淋巴细胞浸润数量显著增加.16周后,模型组中多数大鼠在肠壁可见肿瘤结节,有溃疡坏死和菜花样改变.20周后,模型组大鼠的结肠结构紊乱,肿瘤血运丰富,有大量淋巴细胞浸润.对照组大鼠在实验期间未见异常.结肠癌累计成瘤率为85.71％,随着诱导时间增加,模型组大鼠的结肠癌发生率逐渐增加,结肠癌大鼠的分化程度逐渐向低分化发展,浸润癌、转移癌的比例逐渐增加,差异有统计学意义(P<0.05).模型组大鼠的肠杆菌、肠球菌数目明显上升,乳酸杆菌、双歧杆菌数目明显下降,与对照组大鼠相比,差异有统计学意义(P<0.05).结论 经皮下注射DMH能够成功建立与人结肠癌类似的结肠癌大鼠模型.结肠癌大鼠模型的肠道菌群结构和数目明显偏移,肠道菌群变化在结肠癌的发生、发展上能够发挥一定作用.

目的 探讨腹腔镜间质瘤切除术与开腹胃间质瘤切除术对机体炎症反应和免疫功能的影响.方法 收集行胃间质瘤根治术且具有完整病例资料的患者140例,根据手术方式分为腹腔镜组(78例)和开腹组(62例),比较两组患者术前和术后的炎症指标和免疫指标.结果 术前第1天,两组患者炎症指标和免疫指标之间的差异无统计学意义(P>0.05).术后第1天和第7天,腹腔镜组中CD3+、CD4+、CD4+/CD8+及IgG、IgM、IgA的表达较开腹组高,IL-6、TNF-α和CRP的表达较开腹组低;差异均有统计学意义(均P<0.05).结论 与开腹胃间质瘤切除术相比较,腹腔镜胃间质瘤切除术能够有效降低术后炎症反应的程度,且对机体的免疫功能影响更小.

目的 系统性评价肠内营养应用于术前肠道准备对结直肠癌患者腹腔和肠腔脱落癌细胞及预后的影响.方法检索建库至2017年3月中国知网(CNKI)、万方数据库、维普数据库(VIP)、Pubmed、Embase、Medline、Coehrane library、Web of Science有关肠内营养与机械性肠道准备用于结直肠癌患者术前肠道准备的对比研究文献.对肠内营养肠道准备组与机械性肠道准备组患者腹腔脱落癌细胞阳性率、肠腔脱落癌细胞阳性率、局部复发率、远处转移率、3年生存率等数据进行Meta分析.数据分析应用RevMan 5.3软件.结果共4篇随机对照研究文献纳入本研究,444例结直肠癌患者纳入Meta分析,其中肠内营养肠道准备组222例,机械性肠道准备组222例.与机械性肠道准备组比较,肠内营养肠道准备组患者腹腔脱落癌细胞阳性率(OR=0.22,95％CI:0.10～0.51,P<0.05)和肠腔内脱落癌细胞阳性率(OR=0.32,95％CI:0.19～0.54,P<0.05)均降低,但术后局部复发率(OR=0.72,95％CI:0.19～2.01,P>0.05)、远处转移率(OR=1.01,95％CI:0.42～2.42,P>0.05)和3年生存率(OR=1.14,95％CI:0.69～1.86,P>0.05)比较差异均无统计学意义.结论肠内营养应用于结直肠癌患者术前肠道准备可降低腹腔和肠腔脱落癌细胞阳性率,且不影响术后局部复发率、远处转移率和3年生存率.

目的 探讨快速康复外科(FTS)对腹腔镜远端胃癌根治术患者炎症反应和免疫功能的影响.方法 244例腹腔镜远端胃癌根治术患者按围手术期处理方法不同分为快速康复外科(FTS)组126例和传统组118例,对两组患者术前和术后炎症指标、免疫指标和术后并发症进行比较.结果 术后第3、7天,FTS组患者外周血淋巴细胞亚群CD3+、CD4+、CD4+/CD8+水平显著高于传统组[CD3+:(58.33±5.17)％比(51.78±5.40)％、(62.56±6.64)％比(55.58±7.16)％,P<0.05;CD4+:(26.79±3.03)％比(23.34±2.63)％、(29.01±3.83)％比(25.16±2.97)％,P<0.05;CD4+/CD8+:(1.27±0.12)％比(1.04±0.17)％、(1.49±0.24)％比(1.20±0.22),P<0.05];术后第3、7天,FTS组患者外周血IgA、IgM、IgG水平显著高于传统组[IgA:(1.73±0.18)g/L比(1.53±0.20)g/L、(1.87±0.16)g/L比(1.62±0.23)g/L,P<0.05;IgM:(0.94±0.16)g/L比(0.70±0.27)g/L、(1.30±0.19)g/L比(1.02±0.21)g/L,P<0.05;IgG:(10.20±1.44)g/L比(8.22±1.48)g/L、(12.58±1.29)g/L比(10.13±1.50)g/L,P<0.05];术后第1、3、7天,FTS组患者外周血IL-6、CRP、TNF-α水平显著低于传统组[CRP:(59.41±10.72)mg/L比(72.91±8.78)mg/L、(29.86±8.67)mg/L比(39.31±8.65)、(9.73±4.05)mg/L比(16.37±5.41)mg/L,P均<0.05;IL-6:(59.19±9.21)ng/L比(79.87±12.01)ng/L、(19.14±8.59)ng/L比(27.69±6.69)ng/L、(10.21±4.64)ng/L比(15.56±4.72)ng/L,P均<0.05;TNF-α:(150.98±10.28)ng/L比(165.24±16.08)ng/L、(125.06±15.63)ng/L比(147.56±17.99)ng/L、(107.96±15.98)ng/L比(123.44±13.45)ng/L,P均<0.05];FTS组术后并发症发生率明显低于传统组,差异有统计学意义(P<0.05).结论 快速康复外科能有效降低胃癌根治术患者炎症反应程度和术后并发症发生率,对机体免疫功能影响更小.

Objective To compare the quality of life,nutritional status and immune function of gastric cancer patients with digestive tract reconstruction using Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis after radical gastrectomy.Methods 86 patients with gastric cancer were selected from May 2015 to June 2017 with radical total gastrectomy.According to the different ways of the reconstruction of the digestive tract,the patients were divided into URY group (non-severed group,41 patients) and RY group (traditional group,45 patients).The quality of life of the two groups was compared at 1 month,3 months and 6 months after operation.The nutritional status of albumin,prealbumin,transferrin,hemoglobin,retinol binding protein and weight,as well as CD4+ lymphocyte,CD8+ lymphocyte,CD4+/CD8+ ratio,IgG,IgM,IgA and other immune related indexes were observed at pre-operation and 1 month,3 months and 6 months after operation.Results As for quality of life,the score of diet limitation in group URY was significantly lower than that in group RY at 1 month after operation (P＜0.05),and no significant difference at 3 months and 6 months after operation (P＞0.05);As for anxiety,the score of group URY was higher than that in group RY (P＜ 0.05) at 1 month after operation (P＜0.05),and was lower than that in group RY at 3 months and 6 months after operation (P＜0.05).As for dry mouth,group URY was higher than that in group RY (P＜0.05) at 3 months and 6 months after operation (P＜0.05),and the other indexes were not statistically significant (P＞ 0.05).As for the nutritional indexes,prealbumin in the URY group was higher than that in the RY group at 6 months after operation (P＜0.05),and the rest were not statistically significant (P＞0.05).There was no statistical significance in immune indexes between the two groups (P ＞ 0.05).The postoperative hospitalization time of URY group was less than that of RY group (P＜0.05),and the incidence of mild reflux symptoms was lower than that of RY group (P＜0.05).There was no significant difference in the incidence of other complications between the two groups (P＞0.05).Conclusion Except for the length of hospitalization and postoperative complications in which uncut Roux-en-Y anastomosis was superior to Roux-en-Y anastomosis,there is no significant difference in quality of life and nutritional and immune indicators between the two alimentary tract reconstruction methods.

目的:探讨腹腔镜探查联合Lichtenstein或经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)治疗腹股沟嵌顿疝的手术方法,评估发生绞窄且行肠切除时放置合成补片的安全性.方法:回顾分析2013年9月至2015年12月因腹股沟嵌顿疝就诊且经手术治疗的71例患者的临床资料,其中35例腹腔镜探查后行Lichtenstein手术(Lichtenstein组),36例行TAPP(TAPP组).71例患者中60岁以上占64.8％,男性占78.9％,嵌顿时间平均(17.2±22.6)h;术后随访25～52个月,平均(39.1±8.3)个月.比较两组术后近远期并发症发生率及临床疗效.结果:7例因发生绞窄而行肠切除术.TAPP组住院时间、恢复日常活动时间与工作时间均优于Lichtenstein组,两组差异有统计学意义.两组并发症发生率差异无统计学意义.结论:在腹股沟嵌顿/绞窄疝的治疗中,如腹腔镜下探查判断肠管失活,先于镜下完成肠切除肠吻合术,联合Lichtenstein放置大孔聚丙烯补片是安全、有效的.

目的 探讨加速康复外科(ERAS)理念在胃癌根治术中的临床应用效果.方法 回顾性选取我院普外科2014年3月～2017年6月收治的采取根治性全胃切除的胃癌患者84例,根据围术期处理方式的不同分为ERAS组(n=41)和传统组(n=43),记录并比较两组患者围术期情况和并发症发生率.结果 ERAS组和传统组相比,肛门排气时间缩短,术后下床活动时间和术后首次进食流质时间显著提前,术后住院时间缩短(均P＜0.05);术后总的并发症发生率,ERAS组显著低于传统组(9.8％比34.9％,P＜0.05);两组患者均无肿瘤复发及死亡,吻合口狭窄和十二指肠残端瘘两组均未发生.结论 胃癌根治术围手术期采用加速康复外科(ERAS)理念,安全有效,可以使患者更快的康复,并减少术后并发症的发生.

术后胃瘫综合征(postoperative gastroparesis syn-drome,PGS)是腹部手术后早期常见的并发症.它主要发生在胃十二指肠手术后,也发生在非胃十二指肠手术中,是一种具有胃动力障碍和胃肠道非机械性阻塞特征的功能性疾病[1].PGS 的发病率随着手术的展开和手术时间的延长而增加[2].据报道,胰十二指肠切除术后 PGS 发生率达到 20％～50％,远端胃癌切除术后其发病率约为 4％～5％[3].大多数胃瘫患者单纯使用药物难以治愈,目前胃瘫的治疗都是综合治疗,包括饮食调整,血糖控制,止吐药物,促动力药物和手术干预,如胃电刺激(gastric electrical stimu-lation,GES),肉毒杆菌注射,幽门成形术等[4],但临床疗效不理想.本文对可能引起胃瘫的因素进行非条件 Logistic 回归分析,探讨引起胃瘫的危险因素,为临床诊治提供参考.

Objective To compare the safety and short-term efficacy between uncut Roux-en-Y anastomosis and traditional Roux-en-Y anastomosis in digestive tract reconstruction after totally laparoscopic distal gastrectomy. Methods Retrospective analyzed the clinical data of 43 patients with total laparoscopic radical gastrectomy for gastric cancer between January 2015 and June 2016(23 patients with uncut Roux-en-Y anastomosis,20 patients underwent conventional Roux-en-Y anastomosis),and the perioperative related indicators and postoperative follow-up of the two groups were analyzed retrospectively. Results Compared with group B,group A had shorter time in digestive tract reconstruction and less blood loss(P<0.01). The operation time of group A was shorter than that of group B(P<0.05). After 6 months follow-up,none of the two groups died, and the incidence of postoperative complications was similar(P>0.05). Conclusion Uncut Roux-en-y digestive tract anastomosis after laparoscopic distal gastrectomy for gastric cancer has the advantages of short operation time and low bleeding volume,and does not increase the incidence of postoperative adverse reaction,and it is worth clinical application.

长期吞咽困难的患者需要肠内营养(EN)支持以维持正常的生命活动,提高生活质量.目前最常用的EN方式是经皮内镜下胃造瘘术(PEG),它的优点主要是创伤小、并发症发生率低、术后恢复快,然而在一些特殊患者或者PEG尝试失败的患者,腹腔镜辅助下的经皮内镜胃造瘘术(LAPEG)获得了更多的重视,本文就近几年在特殊患者或PEG尝试失败的患者中使用LAPEG的研究进行探讨,为临床施治提供依据.

objective:through the meta analysis of Dahuang Mudan decoction combined with antibiotics in the treatment of appendicitis postoperative literature and simple use of antibiotics in the treatment of appendicitis postoperative assessment of Dahuang Mudan decoction in the treatment of clinical curative effect after appendectomy.Methods:Searching the article up to April 2016 in Chinese knowledge network (CKNI), Wanfang database, VIP database (VIP), Pubmed.Coehrane library, Web of Science literature comparative study on Dahuang Mudan decoction combined with antibiotics and antibiotic therapy alone after appendectomy treatment.Total effective rate of the treatment, the recovery time of bowel sound, anal exhaust time, hospitalization time, incision infection, defecation time and other data were meta analysis data analysis using RevMan 5.3.Software.Results:A total of 8 randomized controlled trials included in this study, analysis of the meta into a total of 745 patients, including appendix resection after use the treatment of Dahuang Mudan decoction combined with antibiotics in the 371 patients, postoperative antibiotics alone there were 374 cases of Dahuang Mudan decoction combined with antibiotics in the treatment group has higher treatment efficiency (OR=3.65, CI:1.59-8.38,P＜0.01), anal exhaust faster (WMD=-11.23, CI:-15.46 ～-6.99,P＜0.01) and defecation time (WMD=-15.75, CI:-20.17 ～-11.34,P＜0.01), shorter hospitalization time after operation (WMD=-1.15, CI:-1.58 ～-0.72,P＜0.01) and a shorter recovery time of bowel sounds (WMD=-6.23, CI:-7.47 ～-4.98,P＜0.01) and the rate of complications of incision infection less postoperative (OR=0.29, CI:0.16-0.53,P＜0.01).Conclusion:Dahuang Mudan decoction Combined with antibiotics in the treatment of appendicitis after resection compared with the use of antibiotics has obvious curative effect, worthy of clinical use.

OBJECTIVE The study aimed to investigate the expression of tumor necrosis factor receptor-associated factor 6 (TRAF6)in patients with gastric cancer and its relationship with the nutritional status and prognosis.METHODS RT-PCR, Western-blot and ELISA were used to detect the expression of TRAF6 Mrna and TRAF6 protein in samples (rectus abdominis muscles,serum)of 102 patients with gastric cancer and 53 patients with benign abdominal diseases.The results were analysed combined with the clinical data.RESULTS The relative expression of TRAF6 Mrna in rectus abdominis muscles of gastric cancer patients (3.89±0.09)was significantly upregulated compared with the control group (1.77±1.08),the difference was statistically significant (t=13.050,P<0.001).The expression of TRAF6 protein in rectus abdominis muscles of gastric cancer patients was upregulated compared with the control group (P<0.05).The relative expression of TRAF6 protein in serum of gas-tric cancer patients (4.89±1.09)was significantly higher than those in the control group (2.78±1.18),the difference was sta-tistically significant (t=14.595,P<0.001).The high expression of TRAF6 protein in serum of gastric cancer patients was sig-nificantly associated with the percentage of weight loss,lower level of serum albumin and lower level of hemoglobin (χ2 values were 12.901,17.422 amd 4.886,P values were <0.001,<0.001 and 0.027).The high expression of TRAF6 protein in serum of gastric cancer patients was related to the pathologic type,lymph node metastasis and TNM stage (χ2 values were 6.154, 10.237 and 7.727,P values were 0.046,0.001 and 0.005).The high expression of TRAF6 protein in serum was related to the survival rate of gastric cancer patients (χ2 =6.641,P =0.010).CONCLUSIONS TRAF6 Mrna and protein are upregu-lated in rectus abdominis muscles and serum of gastric cancer patients.The high expression of TRAF6 protein in serum of gastric cancer patients is related to the poor nutritional status and prognosis,which might play an important role in the de-velopment of cachexia.

目的 探讨康艾注射液辅助化疗治疗晚期胃癌的临床疗效.方法 选取晚期胃癌36例,按随机数字表分为联合组(化疗+康艾)和化疗组,两组各18例,联合组在奥沙利铂联合替吉奥(S-1)化疗的基础连用康艾注射液静滴;化疗组只使用奥沙利铂联合替吉奥(S-1)进行化疗.结果 联合组近期治疗的有效率为72.2％,高于化疗组的38.9％;联合组近期疾病控制率为88.9％,高于化疗组的55.6％;联合组毒副反应发生的例数明显低于化疗组,差异均有统计学意义(均P＜ 0.05).联合组化疗后KPS评分为(72.67±1.76)分,高于化疗组的(65.73±3.15)分;联合组化疗后生活质量评估表(QLQ-C30)评分为(68.67±1.29)分,低于化疗组的(73.13±2.83)分,差异均有统计学意义(均P＜0.05).联合组患者的中位生存期(OS)为22个月,高于化疗组的15个月,差异有统计学意义(P＜0.05).结论 康艾注射液辅助化疗可以提高晚期胃癌患者治疗的临床疗效,值得临床推广使用.

胃癌是常见的上消化道恶性肿瘤之一,胃癌患者在中晚期容易出现营养不良和免疫功能抑制,甚至恶质病.行胃大部或全胃切除术后的患者由于手术创伤、禁食、感染等应激作用,机体处于高分解代谢状态,蛋白质分解代谢速度大于合成速度,机体蛋白质丢失,出现负氮平衡,进一步加重了患者营养状态的恶化及免疫功能的破坏,免疫抑制和营养不良在术后会严重影响患者伤口的愈合、肠道屏障功能的恢复,引发术后并发症,最终导致患者的代谢、内分泌、神经内分泌功能的紊乱,严重者可危及生命,所以提高胃癌术后患者的免疫力和营养状态是治疗的关键.含有ω-3不饱和脂肪酸的肠内营养制剂是临床上最常见的免疫营养制剂,本研究比较使用含ω-3不饱和脂肪酸的肠内营养制剂和不含ω-3不饱和脂肪酸的普通肠内营养制剂,探究ω-3不饱和脂肪酸对胃癌术后患者免疫力的影响.