纽纯素在结肠癌病人术后肠内营养支持中的应用

Therapeutic effects of enteral nutrition with Nutren in patients with colon cancer receiving colon operation

目的 :用纽纯素 (Nutren)作为肠内营养制剂 ,对结肠癌病人术后进行肠内营养治疗。 方法 :6 0例结肠癌病人 ,平均年龄 (5 2 .5 3± 13 .0 4)岁 ,随机分为肠内营养纽纯素组 (EN)和静脉营养对照组 (PN) ,每组 30人。按体重每天供给热能 12 5kJ(30kcal) /kg和蛋白质 1.2 5 g/kg(0 .2 g氮 /kg) ,热氮比值为非蛋白热能 6 2 7.6kJ(15 0kcal)∶1g氮。 结果 :EN组未见有恶心、呕吐、腹胀、腹泻等胃肠反应。全部病人的切口均Ⅰ期愈合。体重、握力、上臂围(MAC)、上臂肌围 (MAMC)、肱三头肌皮褶厚度 (TSF)、外周血淋巴细胞总数、血红蛋白 (Hb)、总蛋白 (TP)、白蛋白(A)、尿素氮 (BUN)、肌酐 (Cr)、钠 (Na)、钾 (K)、氯 (Cl)、血糖、胆固醇 (Tch)、甘油三酯 (TG)等指标均在正常范围内。EN组血清谷氨酰胺和谷氨酸水平高于PN组 ,有显著差异 (P <0 .0 5 ) ,其余氨基酸无差异。PN组尿乳果糖 /甘露醇比率 (L/M)升高 ,与EN组相比 ,有显著差异 (P <0 .0 5 )。 结论 :纽纯素对术后结肠癌病人有明显的营养治疗效果和维护肠粘膜通透性的作用。

Objectives:To observe the effectiveness of enteral nutrition therapy using Nutren in patients after colon operation for cancer. Methods:60 cases of patients with colon cancer were randomized into enteral nutrition group(EN) and parenteral nutrition group(PN),each 30 cases.They were given with non protein energy of 125 kJ(30 kcal)/(kg·d),protein of 1.25 g(0.2 gN)/(kg·d) and non protein energy nitrogen ratio of 627.6 kJ(150 kcal)∶ 1 gN. Results:There were no gut reactions such as nausea,vomiting,abdomen bulge,diarrhea in EN group during the experiment.There were no differences in body weight,grip,MAC,MAMC,TSF,TLC,Hb,TP,A,BUN,CR,Na,K,Cl,blood sugar,serum Tch and TG between two groups.The serum concentrations of glutamine and glutamate acid in EN group were higher than those in PN group( P <0.05).The urine L/M ratio in PN group was significantly increased when compared with that in EN group on the 9th day of postoperation. Conclusions:The enteral nutrition with Nutren is helpful in improving intestinal permeability in patients receiving colon operation.