贲门癌根治术后丙氨酰-谷氨酰胺双肽强化的肠外营养的支持作用

Support of Ala-Gln-enriched parenteral nutrition on radical resection of cardiac carcinoma patients

目的评价添加丙氨酰-谷氨酰胺双肽（Ala-Gln）的肠外营养（PN）对贲门癌根治术后病人的治疗作用。方法将贲门癌根治术后病人80例随机分为研究组（Ala—Gin强化的PN）及对照组（常规PN），每组40例。术后第1～7d予以营养支持治疗，比较两组病人的体重变化、术后平均住院日，并测定血浆谷氨酰胺（Gin）、血浆白蛋白、血清内毒素水平。结果手术前后，研究组体重无明显变化，对照组体重平均下降（4．8±2．5）kg；研究组术后平均住院日为（10．5±3．1）d，与对照组（15．2±2．4）d比较差异显著（P〈0．01）；术后研究组血浆Gin水平下降不明显，而对照组显著下降，二者差异显著（P〈0．01）；研究组术后7d血浆白蛋白浓度明显回升（39．76±4．32）g／L，与对照组（32．87±3．85）g／L比较，有显著性差异（P〈0．01）；研究组术后血清内毒素水平增加不明显，而对照组明显增加，两者差异显著（P〈0．01）。结论Ala-Gln强化的PN能显著提高贲门癌根治术后病人的血浆Gin水平，有效改善手术导致的负氮平衡，提高血浆白蛋白水平，保护肠黏膜屏障，减轻高内毒素血症，改善预后，促进病人的康复。

Objective To evaluate the curative effect of Ala-Gln-enriched parenteral nutrition （PN）on radical resection of cardiac carcinoma patients. Methods Eighty cases were randomly divided into treatment group（n = 40）and control group（n = 40）. The former were supported with Ala-Gln plus PN and the latter only with PN for 7 days. The weight and postoperative average hospital stay were observed. Serum levels of Gin,albumin and endotoxin were tested. Results As compared with the control group, the weight and serum Gln levels in the treatment group were descended insignificantly（P〉 0. 05 ） ; Postoperative average hospital stay was shortened significantly（ P〈0. 01 ） ; Serum albumin levels was increased obviously at 7 th postoperative day;Serum endotoxin levels were increased insignificantly（P〉0. 05）. Conclusion Ala-Gln could increase serum Gln and albumin levels, effectively improve nitrogen balance of radical resection of cardiac carcinoma patients, and is helpful to maintain the mucous barrier function and effectively decrease endotoxin translocation.