含谷氨酰胺的肠内营养对肠癌患者术后营养状况和免疫功能的影响

Effect of Glutamine Enteral Nutrition on Nutritional Status and Immunological Function in Patients with Colorectal Cancer after Operation

目的探讨含谷氨酰胺的肠内营养对肠癌术后患者营养状况和免疫功能的影响。方法 66例结直肠癌术后患者按随机数字表法分为3组,每组22例,含谷氨酰胺肠内营养组(Gln组)给予含谷氨酰胺营养液肠内营养,常规肠内营养组(EN组)给予普通肠内营养,肠外营养组(PN组)给予普通肠外营养,3组疗程均为10 d。观察3组患者术前1 d、术后1 d、10 d的营养、免疫指标及手术情况。结果术后10 d,Gln组体重(BW)、肱三头肌皮褶厚度(TSF)、上臂肌围(AMC)、白蛋白(ALB)均明显优于EN组和PN组(P均<0.05),且ALB高于PN组(P均<0.05),总蛋白(TP)低于EN组(P<0.05),术后10 d,Gln组CD4+、CD4+/CD8+、IgA明显高于EN组(P均<0.05),CD8+明显低于EN组,并且CD4+、CD4+/CD8+明显高于PN组(P均<0.05)。3组肛门排气时间、拆线时间、并发症发生率差异无统计学意义(P>0.05),住院时间Gln组、EN组长于PN组(P<0.05)。结论应用含谷氨酰胺的肠内营养对改善肠癌患者术后营养状态和免疫功能有一定作用。

Objective To investigate the effect of glutamine enteral nutrition （ EN ） on nutritional status and immunological function in patients with colorectal cancer after operation .Methods Sixty-six patients with colorectal cancer after operation were randomly divided into 3 groups according to the random number table , with 22 cases in each group,the glutamine enteral nutrition group （Gln group） was given enteral nutrition with glutamine nutrition liquid ,the conventional enteral nutrition group （ EN group ） was given normal enteral nutrition , the parenteral nutrition group （ PN group） was given normal parenteral nutrition .The treatment lasted for 10 days in 3 groups.The nutrition,immune parameters and operation conditions of patients in 3 groups were observed one day before operation ,1,10 days after operation , respectively.Results Ten days after operation,the body weight （BW）,triceps skin-fold thickness（TSF）,arm muscle circumference （AMC）,albumin（ALB） level in Gln group were superior to those in EN and PN groups （all P〈0.05）, the level of total protein （TP） was lower than that in EN group （P〈0.05）;Ten days after operation ,the levels of CD4 ＋, CD4 ＋/CD8＋,IgA in Gln group were significantly higher than those in EN group （all P〈0.05）,the level of CD8＋was significantly lower than that in EN group （ P〈0.05）,and the levels of CD4＋、CD4 ＋/CD8＋were significantly higher than those in PN group （all P〈0.05）.There was no significant difference in the anal exhaust time ,clearing time and incidence of complications among 3 groups（P〉0.05）,while the hospital stay in Gln,EN groups was longer than that in PN group （ P〈0 .05 ） .Conclusion Glutamine enteral nutrition plays a certain role in the improvement of nutrition state and immune function in patients with colorectal cancer after operation .