NİHAT KAYMAKÇIOĞLU, ABDURRAHMAN ŞİMŞEK, MUTLU YAKUT, SERHAT OĞUZ, AKİF TAN, ALİ ŞENGÜL, SAADETTİN ÇETİNER

GATA, Genel Cerrahi ABD, immünoloji BD, ANKARA

Abstract

Investigating the malnutrition of surgical patients and the effects of total enteral nutrition TEN onimmunologic reactions. Malnutrition is an important risk factor for mortality and morbidity as it causes immunologic deficiency. In these patients the possibility of nutritional treatment, surgeons tend to find methods of early diagnosis of malnutrition and the nutritions status of the patients. In this prospective randomized clinic trial; 16 patients were given TEN for 10 days. The malnutrition is evaluated by nitrogen balance. In order to evaluate immunologic status, immunoglobulin and complement levels, lymphocytic response to phytohemagglutinin, the levels of electrophoretic proteins, and skin tests of delayed hypersensitlvity is used. Wilcoxon matched test is used for statistical analysis. When we compared the nitrogen balance before and after the TEN, we found on significant increase (p<0.01)The increase of total lymphocyte count, albumin /globulin ratio, and T-lymphocyte activation is found significant. (p<0.05) The lymphocytic response to phytohemagglutinin is found to be a quite important parameter. The results of the skin tests before and after the TEN is found to be significant(p<0.02). TEN has a positive effect on anergic reactions in malnourished patients. It is found that TEN corrects and improves the cellular immune response.

Keywords: SURGERY, MALNUTRITION, TOTAL ENTERAL NUTRITION, IMMUNOLOGY