口服谷氨酰胺对肝部分切除患者术后的影响

Influences of oral Glutamine in patients with partial hepatectomy

目的评价口服谷氨酰胺对肝癌肝部分切除患者术后的临床治疗效果。方法采用前瞻性、随机、对照的方法,将120例肝癌患者随机分为谷氨酰胺组和对照组,各60例。术后两组患者都接受同样的肠外营养支持治疗,排气后予流质饮食。术后3d起谷氨酰胺组口服谷氨酰胺(30g/d),对照组只给予流质饮食,对比两组患者的肝功能和并发症发生情况。结果谷氨酰胺组术后7d肝功能各项指标包括血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)以及血清总胆红素(TBIL)下降优于对照组(P<0.05),白蛋白(ALB)水平高于对照组(P<0.05),其切口裂开、胸水、膈下积液等并发症的发生率低于对照组(P<0.05)。结论口服谷氨酰胺有益于肝癌肝部分切除患者术后肝功能的恢复,可减少术后并发症的发生,有一定的临床应用价值。

Objective To evaluate the clinical therapeutic efficacy of oral Glutamine in patients with partial hepatectomy. Methods A randomized controlled trial was designed, 120 cases of patients suffered from HCC after partial hepatectomy were randomly dividened into two groups. The treatment of both groups were the same except that Glutamine group was supplemented by oral Glutamine. The liver function and complications were compared in two groups. Results The index of the liver function during postoperative 7 d in Glutamine group including serum aspartate aminotransferase（AST）, alanine aminotransferase（AST） and serum total bilirubin （TBIL）, were better than the control group, P〈0.05. Albumin （ALB） on postoperative 7 d was higher than the control group, P〈0.05. The incidence rate of complication was higer in control group, P〈0.05. Conclusions Oral Glutamine is helpful to the restoration of liver function in patients with partial hepatectomy. It can reduce the incidence of postoperative complications, which have a certain clinical value.