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目的 观察添加益生菌对老年消化道手术术后肠内营养(EN)相关性腹泻的预防作用.方法 将入选的170 例术后经鼻饲行EN支持的食管癌或胃癌患者随机分为治疗组和对照组, 每组85例, 两组术后均给予EN支持并常规护理, 治疗组加用双歧杆菌乳杆菌三联活菌片, 每次3 g, 每日3 次,鼻饲第7d测定外周血炎性介质、免疫球蛋白、 T细胞亚群变化, 记录鼻饲期间腹泻、腹胀等消化道不良反应发生率.结果 鼻饲7 d 后, 治疗组肿瘤坏死因子α (58.5 ± 14.3 vs 73.3 ± 18.4) pg/ml、 C 反应蛋白(13.6 ±4.0 vs17.8 ±4.6) mg/L 显著低于对照组(P <0.05);治疗组 T 细胞亚群 CD4 +/CD8 +比值(1.59 ±0.37 vs 1.52 ±0.31)显著高于对照组(P 0.05);治疗组鼻饲时间(10.4 ±1.9 vs 11.2 ±2.3) d显著低于对照组(P <0.05);鼻饲期间治疗组腹泻(5.9% vs 17.6% )、腹胀(7.1% vs 20.0% )、便秘(1.2% vs 8.2% )发生率均显著低于对照组(P<0.05) .结论 消化道术后 EN 老年患者添加益生菌有助于预防腹泻等消化道并发症的发生;规范护理操作对减少EN相关性腹泻亦具有重要意义.“,”Objective To explore the efficacy of probiotics in prevention of elderly enteral nutrition (EN) associated diar-rhea after digestive tract surgery.Methods 170 postoperative patients supported by nasal feeding after surgery of esophageal or gas-tric cancer were selected.They were randomly divided into the treatment group and the control group.Two groups were given EN sup-port and routine nursing.The treatment group was added with live combined bifidobacterium and lactobacillus tablets.On day 7 of na-sal feeding, inflammatory mediators, immunoglobulin and T cell subsets in peripheral blood were measured.Diarrhea, abdominal dis-tension and other adverse reactions were noted during nasal feeding.Results The levels of TNF-α and CRP in the treatment group were significantly lower than those in the control group (P<0.05).The ratio of CD4 +/CD8 +in the treatment group was significantly higher than that in the control group (P0.05).Feeding time in treatment group was significantly shorten than that in the control group (P<0.05).The incidences of diarrhea, abdominal distension and constipation in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion Probiotics can prevent diarrhea and other gastrointestinal complications in EN support patients.Standardized nursing procedure may contribute to reduce the incidence of EN-associated diarrhea.