谷氨酰胺强化肠外营养对老年结直肠癌患者术后肠道功能及应激状态的影响

Effect of Glutamine-Enhanced Parenteral Nutrition on Intestinal Function and Stress State in Elderly Patients with Colorectal Cancer

目的:探讨谷氨酰胺强化肠外营养对老年结直肠癌患者应激状态及肠道功能的影响。方法:选取我院2019年7月—2021年6月就诊,接受住院治疗的80例老年结直肠癌患者(年龄≥65岁)为研究对象,依据术后肠外营养是否行谷氨酰胺强化分为观察组和对照组各40例,2组患者间性别、年龄、BMI、肿瘤大小及分化程度均无差异(P>0.05),具有可比性。2组患者均行序贯营养支持,观察组患者肠外营养行谷氨酰胺强化。比较2组患者应激状态的变化(血清CRP、IL-6、血糖水平),以及肠道功能恢复情况和并发症发生情况。结果:经1周全肠外营养支持后,观察组患者血清CRP、IL-6及血糖水平已低于术前(P<0.05),且显著低于对照组(P<0.001);观察组患者肠鸣音恢复时间、排气时间和排便时间均短于对照组患者,均有P<0.001;且观察组患者并发症发生率低于对照组(7.50%vs 17.50%,P<0.05)。结论:谷氨酰胺强化肠外营养可改善老年结直肠癌患者应激状态,促进肠道功能的恢复,降低并发症发生率,进而加快围手术期康复,改善疾病预后。

【Objective】To explore the effect of glutamine-enhanced parenteral nutrition on the stress state and intestinal function of elderly patients with colorectal cancer.【Method】We selected 80 elderly patients with colorectal cancer(age≥65 years old)who were hospitalized in our hospital from July 2019 to June 2021 as the research objects.According to whether postoperative parenteral nutrition is supplemented with glutamine,they were divided into observation group and control group,each with 40 cases.There were no differences in gender,age,BMI,tumor size and degree of differentiation between the two groups(P>0.05).Patients in both groups received sequential nutritional support,and parenteral nutrition of observation group were received glutamine fortified.The changes in the stress state(the levels of serum CRP,IL-6,blood glucose),the recovery of intestinal function and the occurrence of complications were compared between the two groups.【Result】After 1 week of total parenteral nutrition,the serum CRP,IL-6,and blood glucose levels of the observation group were lower than before the operation(P<0.05),and significantly lower than the control group(P<0.001).The bowel sound recovery time,exhaust time,and defecation time in the observation group were shorter than those in the control group(all P<0.001)The incidence of complications in the observation group was lower than that in the control group(7.50%vs 17.50%,P<0.05).【Conclusion】Glutamine-enhanced parenteral nutrition can improve the stress state of elderly patients with colorectal cancer,promote the recovery of intestinal function,reduce the incidence of complications,then speed up perioperative recovery and improve the prognosis of the disease.