复方支链氨基酸注射液对结直肠癌根治术后患者的营养支持作用

Effect of compound branch chain amino acid injection on nutritional support in patients after radical resection for colorectal cancer

目的评价复方支链氨基酸注射液对结直肠癌根治术后患者的营养支持作用。方法将50例结直肠癌根治术后患者随机分为研究组和对照组,每组25例。研究组使用10．3%复方支链氨基酸注射液；对照组使用10．4%复方氨基酸注射液。比较两组患者血清总蛋白、白蛋白、前白蛋白、转铁蛋白的浓度和氮平衡及术后并发症的发生情况。结果术后第8天,研究组与对照组营养状况比较：白蛋白浓度[(36．12±3．16)g/L与(30．61±3．55)g/L]比较,P＜0．05；前白蛋白浓度[(237．10±37．29)mg/L与(191．73±27．60)mg/L]比较,P＜0．05；转铁蛋白浓度[(2．18±1．34)g/L与(1．71±0．84)g/L]比较,P＜0．05；差异均有统计学意义。研究组氮平衡从术后第5天始优于对照组,为9．91±6．53；而对照组第6天仍为负氮平衡(-9．73±11．21)；两组比较P＜0．05；差异有统计学意义。研究组切口感染及愈合不良发生率仅占8．3%,而对照组为38．1%,两组比较P＜0．05；差异有统计学意义。结论结直肠癌术后使用富含支链氨基酸的注射液可减少蛋白分解,尽快改善负氮平衡,并促进伤口愈合。

Objective To evaluate the effect of compound branch chain amino acid（BCAA） injection on nutritional support in patients after radical resection for colorectal cancer. Methods Fifty patients with radical resection for colorectal cancer were randomly divided into two groups, and received compound branch chain amino acid（ n =25） or compound amino acid（ n =25） as control per day from postoperative day（POD） 1 to POD 7. The levels of total protein, albumin, pre-albumin, transferring, nitrogen balance and complications were compared between the two groups. Results On POD 8, the levels of albumin, pre-albumin, transferring were （36. 12±3.16）g/L, （237. 10 ±37.29）mg/L, and （2. 18 ± 1.34） g/L in study group, and （30.61 ± 3. 55）g/L, （191.73 ±27.60） mg/L, and （1.71 ±0.84）g/L respectively in the control group（all P 〈 0. 05） . Nitrogen balance increased significantly from POD5, and increased to normal on POD 6 in study group, significantly higher than that in the control group （9.91±6. 53 vs -9.73± 11.21, P =0. 024）. The complication rate of incision infection and delayed healing was 8.3% in study group, significantly lower than 38. 1% in the control group（ P 〈 0.05）. Conclusion Compared with compound amino acid, compound branch chain amino acid injection can reduce proteolysis, correct negative nitrogen balance and promote wound healing.