谷氨酰胺在大肠癌患者术后肠外支持中的作用

Role of glutamine in total parenteral nutrition in patients with colorectal cancer after surgery

目的:探讨谷氨酰胺(Gln)在大肠癌患者术后完全胃肠道外营养(TPN)中的作用。方法:60例大肠癌患者随机分为实验组(肠外营养加谷氨酰胺)和对照组(常规肠外营养),观察氮平衡、血浆白蛋白水平、术后疲劳评分等各项指标的变化。结果:对照组术后平均住院时间(13.12±3.21)d,实验组(10.90±2.81)d,两者比较有显著性差异(P<0.05);两组患者术前血浆白蛋白水平相似,术后8 d实验组白蛋白水平普遍高于对照组,但两者之间无统计学差异;术后8 d实验组氮平衡明显改善,与对照组相比差异十分显著(P<0.01);术后8 d实验组患者主观感觉好于对照组(P<0.05)。结论:大肠癌患者术后予以肠外营养加谷氨酰胺支持,比常规肠外营养更有利于术后负氮平衡的改善及血浆白蛋白的恢复,并能缩短住院时间、减少术后并发症、显著改善术后疲劳。

Objective： To investigate the role of glutamine in the total parenteral nutrition in patients with colorectal cancer after surgery. Methods： Sixty patients were randomly divided into experimental group and control group,and the patients were treated with glutamineintensified TPN and standard TPN,respectively. The nitrogen balance,serum albumin level,and postoperative fatigue score were determined. Results： The average hospital stay in experimental group was significantly shorter than that in control group （ 13.12±3.21 vs. 10.90±2.81 d,P 〈 0.05）. The serum albumin levels in these 2 groups were similar before surgery. Eight days after surgery,the serum albumin level in experimental group was higher than that in control group, but no significant difference was found. The nitrogen balance and postoperative fatigue score in experimental group were significantly better than those in control group 8 days after surgery （P 〈 0.01 and P 〈 0.05,respectively）. Conclusion： The glutamine-intensified TPN is better than standard TPN in patients with colorectal cancer.