谷氨酰胺强化的肠内营养在胃癌术后中的应用  

Therapeutic effects of glutamine-enriched enteral nutrition in postoperative patients with gastric carcinoma

作　　者：戴寅[1] 傅斌生[1] 魏忠[1] 谢钊[1] 赵旭辉[1] 

机构地区：[1]安徽省立医院分院普外科,合肥230031

出　　处：《安徽医学》2006年第2期100-102,共3页Anhui Medical Journal

摘　　要：目的总结我科30例胃癌术后早期应用肠内营养支持的经验,评价谷氨酰胺强化的肠内营养临床效果的优越性。方法30例接受手术的胃癌患者,随机分为强化肠内营养组和标准肠内营养组,每组各15例。手术后早期(24小时)经术中放置的鼻空肠管应用能全力作为基础肠内营养,添加谷氨酰胺颗粒(安凯舒)作为强化肠内营养。术前、术后7天测定血浆白蛋白、前白蛋白、转铁蛋白、肝肾功能、血糖、电解质、淋巴细胞计数。结果手术前,两组各项指标差异无显著性(P>0.05),术后7天强化肠内营养组的体重、前白蛋白和转铁蛋白较标准肠内营养组明显增高,差异有显著性(P<0.05),淋巴细胞计数明显高于标准肠内营养组(P<0.05)。个别患者出现腹胀、腹泻、经对症治疗缓解,全组患者均能耐受早期肠内营养。未发现有肝、肾功能、血糖、电解质异常。结论胃癌术后早期进行肠内营养安全有效,和标准肠内营养相比,谷氨酰胺强化的肠内营养更有优越性。Objective To evaluate the superiority of early use of glutamiue - enriched euteral nutrition in postoperative patients with gastric carcinoma. Methods Thirty patients with gastric carcinoma were randomized into enriched nutrition group （n=15 ） and standard enteral nutrition group （n = 15 ）. Enteral nutrition was started 24 hours after operation via naso -jejunum tube placed during operation. Weight, serum total protein, aldumin, pre - albumin, transferrin, hepatic and renal function, blood glucose,electrolytes and lymphocyte count were tested at preoperation and at the day 7 after operation. Results There were no significant differences in both nutritional and immune parameters between groups before operation. In the glutamine - enriched enteral nutritional group,levels of weight,pre - albumin,transferrin at postoperative day 7 were higher than those of standard enteral nutritional group （ P 〈 0.05 ）. Lymphocyte count also increased significantly （ P 〈 0.05 ）. Just a few patients experienced abdominal distension and diarrhea but recovered well after treatmenl. All patients tolerated early EN. No abnormality of hepatic and renal function, blood glucose,electrolytes were found in all patients. Conclusion Early use of enteral nutrition after operation was safe and effective. Compared with standard enteral nutrition ,glutamine- enriched enteral nutrition can significantly improve the clinical outcome of postoperative patients with gastric carcinoma.

关 键 词：谷氨酰胺 肠内营养 胃肿瘤 营养支持 

分 类 号：R735.2[医药卫生—肿瘤]