Effect of total parenteral nutrition and early enteral nutrition on gastrointestinal protection and Treg/Th17 immune balance in postoperative children with congenital choledochal cyst
Zhuo Maji, Wei Xiaoming, Shan Dezhi, et al
Department of General Surgery, Qinghai Province Women & Children's Hospital, Qinghai, Xining 810007, China)
Abstract: 【Abstract】 Objective To analyze the effects of total parenteral nutrition (TPN) and early enteral nutrition (EEN) on gastrointestinal protection and the regulatory T cell (Treg)/T helper cell 17 (Th17) immune balance in postoperative children with congenital choledochal cyst (CCC). Method A total of 80 children with CCC admitted to Qinghai Province Women & Children's Hospital from July 2019 to July 2023 were selected as the study subjects by prospective research method, the cases were randomly numbered from 1 to 80 and assigned to the control group (odd numbers, n=40) and the study group (even numbers, n=40). The control group received TPN for one week, while the study group received EEN for one week. The levels of gastrointestinal function indicators, the levels of immune indicators, the levels of nutritional indicators [albumin (ALB), prealbumin (PAB), retinol binding protein (RBP)] before and one week after treatment, and incidence of complications were compared between the two groups. Statistical analysis were performed by the t-test and χ2 test. Result After 3 d and 7 d of treatment, the numbers of Bifidobacterium in the study group were significantly higher than those in the control group [(6.73±0.19) CFU/g, (8.21±0.41) CFU/g vs (6.03±0.29) CFU/g, (7.49±0.22) CFU/g, t values were 12.770, 9.787, respectively, all P<0.001)]; after 3 d and 7 d of treatment, the numbers of Enterococcus and Escherichia coli in the study group were significantly lower than those in the control group [(8.13±0.13) CFU/g, (7.16±0.94) CFU/g, (9.03±0.32) CFU/g, (8.01±0.32) CFU/g vs (8.72±0.10) CFU/g, (8.06±0.66) CFU/g, (9.61±0.30) CFU/g, (8.63±0.34) CFU/g, t values were 22.751, 4.956, 8.363, 8.398, respectively, all P<0.001]. After 3 d and 7 d of treatment, the levels of Th17 in the study group were significantly higher than those in the control group [(9.31±1.10)%, (13.96±2.04)% vs (7.63±1.00)%, (10.20±1.71)%, t values were 7.147 , 8.934, respectively, all P<0.001]. After 3 d and 7 d of treatment,, the levels of Treg and Treg/Th17 in the study group were significantly lower than those in the control group [(17.61±1.89)%, (14.07±1.34)%, 11.90±0.33, 1.16±0.32 vs (18.63±1.69)%, (17.09±1.74)%, 2.41±0.37, 1.86±0.37, t values were 2.544, 8.697, 8.934, and 9.050, respectively, all P<0.001]. The levels of ALB, PAB, and RBP in the study group were significantly higher than those in the control group [(33.06±3.19) g/L, (219.14±31.62) mg/L, (36.12±6.93) mg/L vs (29.63±3.14) g/L, (210.69±29.72) mg/L, (29.68±5.47) mg/L, t values were 5.063, 4.369, 6.106, respectively, all P<0.001]. Conclusion EEN can better protect gastrointestinal function, improve the nutritional indicators of Treg/Th17, reduce the incidence of complications, and provides significant overall therapeutic benefits for postoperative children with CCC
卓玛吉 魏晓明 陕得智 钟一才 史瑞. 全肠外营养和早期肠内营养对先天性胆总管囊肿术后患儿胃肠道保护及 Treg/Th17 免疫平衡的影响[J]. 发育医学电子杂志, 2025, 13(5): 372-378.
Zhuo Maji, Wei Xiaoming, Shan Dezhi, et al. Effect of total parenteral nutrition and early enteral nutrition on gastrointestinal protection and Treg/Th17 immune balance in postoperative children with congenital choledochal cyst. Journal of Developmental Medicine(Electronic Version), 2025, 13(5): 372-378.
2025, Vol. 13 
