左旋肉碱强化全胃肠外营养对老年结直肠癌患者术后感染控制

Effect of levocarnitine-enriched total parenteral nutrition on old patients with colorectal cancer after surgery

目的探讨左旋肉碱(L-CN)强化全胃肠外营养(TPN)对老年结直肠癌患者根治术后的作用及术后感染发生情况。方法 36例手术和病理学确诊老年结直肠癌患者,随机分成标准TPN对照组(TPN组)和L-CN强化组(L-CN组),分别检测术前和术后血白蛋白(Alb)、前白蛋白(PAB)、甘油三酯(TG)、C-反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、空腹血糖(Glu),评估术后体力状况的分级、观察胃肠道功能恢复时间并统计术后感染发生情况。结果 L-CN组术后第6天Alb、PAB、TG、CRP恢复至正常水平或维持术前水平,与TPN组相比,差异有统计学意义(P<0.05);TPN组患者肝功能一过性损害的发生率为55.6%,血糖一过性升高的发生率为44.4%,L-CN组患者发生率均为5.6%,差异有统计学意义(P<0.01);L-CN组患者肠功能恢复时间明显短于TPN组,差异有统计学意义(P<0.05);两组患者术后无感染情况发生。结论 L-CN强化的TPN是老年结直肠癌患者术后营养支持治疗的合适选择,合理控制手术及术后感染对老年直肠癌患者康复有益。

OBJECTIVE To discuss the effect of levocamitine-enriched TPN on patients with colorectal cancer after radical correction.METHODS A total of 36 patients who were diagnosed as colorectal cancer by operation and pathology were randomly divided into TPN group and L-CN-enriched group.Alb,PAB,TG,CRP,ALT and Glu level were detected respectively in both groups before and after operation.The classification of physical status after operation was evaluated and the recovery time of gastrointestinal tract function was observed.RESULTS Alb,PAB,TG and CRP on the 6th day after operation in L-CN group recovered to or maintained the preoperative level compared with TPN group（P0.05）.Transient damage incidence of liver function（55.6%） was compared between both groups,the incidence of transient-hyperglycemia（44.4%） was compared between both groups,（P0.01）;Recovery time of intestinal function was remarkably shorter in L-CN group（5.6%） than that in TPN group,and the difference was statistically significant（P0.05）.There was no significant difference in the physical status classification between both groups,but patients in L-CN group recovered better than those in TPN group.CONCLUSION Levocamitine-enriched TPN is a suitable choice for the nutritional support treatment for patients with colorectal cancer after surgery.