摘要
目的:探讨术后早期应用含丙氨酰-谷氨酰胺的肠外营养对食管贲门癌患者营养状况的影响。方法:49例患者随机分为两组,试验组24例,对照组25例。术后第1天开始分别给予含和不含L-丙氨酰-L-谷氨酰胺的肠外营养1周。术前和术后第8天分别检测血常规、血清蛋白、肝肾功能,记录恢复全量半流质饮食的时间和体重变化情况。结果:试验组和对照组血常规无显著差异。试验组的营养支持前总蛋白、白蛋白和前白蛋白分别为65．7 g／L,37．2 g／L和226．2 mg／L,营养支持后分别为61．1 g／L,34．3 g／L和214．6 mg／L,无显著差异。对照组营养支持前总蛋白、白蛋白和前白蛋白分别为65．1 g／L,38．6 g／L和259．4mg／L,营养支持后分别为58．4 g／L,32．3 g／L和165．8 mg／L,显著降低,且前白蛋白的下降幅度与试验组存在极显著的差异(P<0．01)。试验组营养支持前后血糖无明显变化,而时照组营养支持后血糖明显升高(P<0．01)。两组肝肾功能营养支持前后均在正常范围之内。试验组术后恢复饮食时间平均为6．5 d,显著低于对照组的10．4 d(P<0．01)。试验组体重平均下降2．7 kg,对照组为7．4kg,有极显著差异(P<0．01)。结论:食管贲门癌术后早期应用丙氨酰-谷氨酰胺有助于减少营养不良的反应,提高营养支持的效果,有助于纠正负氮平衡,改善患者营养状况,促进消化功能的恢复和体重的稳定。
Objective：To evaluate the effect of early postoperative use of alanyl-glutamine （dipeptiven） contained total parenteral nutrition （TPN） support on the nutritional status of esophageal-cardiac cancer patients. Methods：49 paitents were randomly divided into two groups, given total parenteral nutrition（TPN） with（dipeptiven group） or without（control group） dipeptiven for 1 week from the first postoperative day. On the day before operation and the 8th day after operation, the blood routine, serum protein, liver and renal function, diet resuming period and weight loss were recorded. Results：For blood routine, there were no difference between the two groups. The serum total protein, albumin and prealbumin level of the dipeptiven group were 65. 7 g/L, 37.2 g/L and 226.2 mg/L, respectively, while after nutritional support were 61.1g/L, 34. 3 g/L and 214. 6 mg/L, respectively, no significant differences were found. The data of the control groups were pre-nutrition 65.1 g/L, 38.6 g/L and 259.4 mg/L, respectively, and post-nutrition 58.4 g/L, 32.3 g/L and 165.8 mg/L, respectively, with statistical significant decreases. The prealbumin decrease of control group was very significant comparing with that of the dipeptiven group （P〈0. 01 ）. There was no change of fasting glucose in dipeptiven group, but showed a significant increase level in the control group （P 〈0.01）. Significant difference existed between the two groups （P〈0.01）. Liver and renal function all maintained in normal range for the two groups. The average diet resuming period of dipeptiven group was 6.5 days, significantly shorter than 10.4 days of control group （P〈0.01）. Also the 2.7kg weight loss of dipeptiven group was significantly less than the 7.4kg of control group （P〈0.01）. Conclusion： Early postoperative use of alanyl-glutamine for esophageal-cardiac cancer patients was effective for eliminating the side effect of TPN, and increased the effect of nutritional support, beneficial for correcting the negative nitrogen balance, thus improving the patients＇ nutritional status, enhancing the resumption of intestinal function and keeping body weight. It was a cost-effective methods for the compensation of TPN.
出处
《中国临床医学》
北大核心
2007年第2期183-185,共3页
Chinese Journal of Clinical Medicine
关键词
食管癌
贲门癌
营养状况
全肠外营养
丙氨酰-谷氨酰胺
Esophageal cancer
Cardiac cancer
Nutritional status
Total parenteral nutrition
Alanyl-glutamine
