高支链氨基酸配方营养支持对消化道术后疲劳的影响

Effect of branch chain amino acid enriched formula on postoperative fatigue and nutritional status after digestive surgery

目的探讨高支链氨基酸(BCAA)配方营养支持对消化道手术后患者营养状态和术后疲劳(POF)的影响。方法将40例消化道手术后患者随机分为两组连续静脉营养1周,研究组给予高BCAA配方,对照组给予普通复合氨基酸,期间对两组患者进行疲劳评分和氮平衡测定及血清总蛋白、白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白等营养指标的测定,并进行比较分析。结果术后第4、5、6天及累计疲劳评分研究组低于对照组(P<0.05)。研究组先于对照组2d恢复正氮平衡,累计氮平衡两组间差异无统计学意义。与术后第1天相比,术后第7天血清总蛋白、白蛋白、前白蛋白和转铁蛋白上升幅度两组相比,差异无统计学意义(P>0.05),视黄醇结合蛋白上升幅度研究组高于对照组(P=0.004)。结论高BCAA配方营养支持可降低术后疲劳程度,具有更佳节氮效果,促进患者康复。

Objective To evaluate the effect of branch chain amino acid (BCA A) enriched formula on nutritional status and postoperative fatigue for digestive surgery patients. Methods Forty patients who underwent digestive surgery were ra ndomly received parenteral nutrition with either BCAA enriched(study group,n=20) or routine amino acid(control group,n=20) for seven consecutive days. Nitrogen balance,serum total protein,albumin,prealbumin,transferrin,retinol binding prote in and postoperative fatigue score were monitored during the postoperative perio d. Results The cumulative postoperative fatigue scores were lower in BCAA group than that in the control group at the 4th,5th and 7th day after operation(P< 0.0 5). Patients achieved positive nitrogen balance 2 days earlier in the study grou p than that in the control group,but there was no significant difference in cumu lative nitrogen balance between the two groups. There was no significant differe nce in elevation of serum total protein,albumin,prealbumin,transferrin at the 7t h day after operation between the two groups(P >0.05),compared with those at the first day after operation. The serum level of retinol binding protein was highe r in BCAA enriched group than that in the control group(P=0.004). Conclusion TP N with BCAA enriched formula can reduce postoperative fatigue score and improve the nutritional status for digestive surgery patients.