| Objective : Qiildren are in a special growth period. Their metabolize rate is higher than adults'. Malnutrition exists among many children who need operatioa Futhermore, after operation, their bodies are in a high catabolism state, and their immune function decrease. So it is necessary to give nutrition support to them.The objectives of this study are :l.To investigate the effects of operation and fasting on the nutrition and immune state of children who took digestive tract reconstruction operation; 2.To analysis the changes of nutrition and immune state of children respectively in ENk PN and control groups ; 3.To compare the differences of increasing level of nutrition and immune parameters among the three groups after nutrition support;4.To study the differences of morbidity and mortality among these groups, and determine which is the best nutrition support way.Methods: Select sixty children needing digestive tract reconstruction operation, whose hepatic functions were rated child A and renal functions were normal before operation, their ages were all above ten months old. they were divided randomized into three groups. Group A: 20 children were given PN since 72 hoursafter operation, nutrition energy increased according to supporting day, gradually added up to 120 percent of BEE.BEE was calculated out by Harris-Benedict formula, supporting time lasted for 7 days. Group B: 20 children were given equal energy of EN at the same time with group A. Group C:20 children were given liquid diet since 72 hours after operation and changed to semiliquid and normal diet gradually. The three Groups were all given anrtbiotic and antibleeding drugs according to needing and enough fluid through vein before nutrition support. Nutrition parameters: weight^ height^ arm circumference (AC) triceps skinfold thickness (TSF)> hepatic function and renal function prealbumin(PA) transferrin(TFN) immune function parameters including immunoglobulin G A M were measured 1 day before operation and 3 10 days after operation Recover of intestine function and morbidity and mortality were observed after operation. Arm muscle circumference (AMC) was Calculated by the formula: AMQcm) =AC(cm>3.14XTSF(cm).Body mass index(BMI) was calculated out by the formula: BMI=W(kg)/HV).Results: The attacks of operation and fasting on patient children deteriorate their nutrition and immune states. There were very significant differences (p<0.01)in weight TSF AMC BMI PA TFN IgG IgA IgM level between preoperation and 3 days after operation. There were very significant differences in all these nutrition parameters between 3 days and 10 days after operation ingroup A and B(p<0.01) But in group C, there were significant differences (pO.05) in PA and TFN, while in other parameters, there were not significant differences between 3 days and 10 days after operation. When comparing dfN and dc, We found all these parameters had significant differences too. In PA and TFN, p<0.05,and others pO.Ol.While comparing dpN and deN, IgA in EN group was higher than it in PN group, with significant difference (p<0.05), but in other parameters there weren't significant differences(p>0.05). There weren't any mortality in all these three groups, when comparing morbidity, there were significant differences between group B and C (p<0.05) but there weren't significant differences between group A and B, or group AandC.Conclusion: The attacks of operation and fasting on children who took digestive tract reconstruction operation degrade their nutrition states and impair their immune functions. If they are not given nutrition support, their bad nutrition state will prolong and be accompanied by negative nitrogen balance Confused endocrine delayed wound healing , and immune function can not recover fast. If given enteral or parenteral nutrition support after operation, their nutrition states and immune functions can recover in relatively short period, and morbidity decreases significantly. Comparing with PN, EN has die advantages of safety Convience cheapment et al. So we c...
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