谷氨酰胺联合ω-3多不饱和脂肪酸肠外营养支持对结直肠癌患者术后营养状况和免疫功能的影响
发布时间：2019-05-17 18:31
【摘要】：目的:研究谷氨酰胺联合ω-3多不饱和脂肪酸(ω-3 polyunsaturated fatty acid,PUFA)肠外营养支持对结直肠癌患者术后营养状况和免疫功能的影响。方法:选择行结直肠癌根治术的患者96例随机分入谷氨酰胺联合ω-3多不饱和脂肪酸肠外营养(ω-3 PUFA+Gln)组、谷氨酰胺强化肠外营养(Gin)组和常规肠外营养(对照)组,各组32例。三组病人从手术结束开始接受等氮和等热量营养支持至少7天,试验组营养液另加谷氨酰胺注射液和ω-3多不饱和脂肪酸注射液,静脉滴注。然后,分别于术前、术后第1天、术后第7天检测并比较体质量(BW)、白蛋白(ALB)、血红蛋白(HGB)、前白蛋白(TF)、转铁蛋白(PA)、外周血T淋巴细胞亚群(CD4+、CD8+)、CD4+/CD8+、IgG、IgM、IgA,并比较3组术后并发症发生率和术后住院时间。采用SAS 9.2统计软件进行统计分析,P值小于0.05表示有统计学意义。结果:三组术后第1天、第7天血红蛋白、血清白蛋白、前白蛋白和转贴蛋白均较术前降低(P0.05),术后第7天ω-3 PUFA+Gln组血清前白蛋白水平高于Gin组和对照组(P 0.05)。三组术后第1天lg G、lgA、lgM、CD4+,CD8+, CD4+/CD8+均较术前下降(P 0.05);术后第7天ω-3 PUFA+Gln组免疫学指标与术前比较差异均无统计学意义(P 0.05),术后第7天Gin组和对照组部分免疫学指标仍低于术前(P 0.05)。co-3 PUFA+Gln组与对照组的术后总的并发症发生率比较差异有统计学意义(χ2=14.930, P0.05); ω-3 PUFA+Gln组与Gin组的术后总的并发症发生率比较差异有统计学意义(χ2=8.772,P0.05);Gln组与对照组的术后总的并发症发生率比较差异无统计学意义(χ2 =0.933,P 0.05)。co-3 PUFA+Gln组、Gln组、对照组的术后住院时间分别为(9.8±3.1) d、(9.5±2.9)d和(12.2±3.9) d,ω-3 PUFA+Gln组与对照组比较差异有统计学意义(t0.05/2,31=4.758,P 0.001); Gln组与对照组比较差异有统计学意义(t0.05/2,31=4.860,P 0.001); ω-3 PUFA+Gln组与Gln组比较差异无统计学意义(t0.05/2,31=0.292, P=0.771)。结论:co-3 PUFA与Gln联合应用可改善结直肠癌患者术后免疫功能和营养状况,并减少术后并发症,缩短术后住院时间。
[Abstract]:Aim: to study the effect of glutamine combined with omega-3 polysaturated fatty acid (omega-3 polyunsaturated fatty acid,PUFA) parenteral nutrition support on postoperative nutritional status and immune function in patients with colorectal cancer. Methods: 96 patients undergoing radical resection of colorectal cancer were randomly divided into glutamine combined with omega-3 polysaturated fatty acid parenteral nutrition (omega-3 PUFA Gln) group). Glutamine fortified parenteral nutrition (Gin) group and routine parenteral nutrition group (control) group, 32 cases in each group. The patients in the three groups received equal nitrogen and equal calorie nutritional support for at least 7 days from the end of the operation. The experimental group was treated with glutamine injection and omega-3 polysaturated fatty acid injection intravenously. Then, the peripheral blood T lymphocyte subsets (CD4) of (BW), albumin (ALB), hemoglobin (HGB), prealbumin (TF), transferrin (PA), were measured and compared before operation, on the first day after operation and on the 7th day after operation. CD8, CD4 / CD8 and IgG,IgM,IgA, were used to compare the incidence of postoperative complications and hospital stay in the three groups. The statistical analysis was carried out by using SAS 9.2 statistical software, and the P value was less than 0.05. it was statistically significant. Results: hemoglobin, serum albumin, prealbumin and transferable protein in the three groups were lower than those before operation on the 1st and 7th day after operation (P 0.05). On the 7th day after operation, the level of serum prealbumin in omega-3 PUFA Gln group was higher than that in Gin group and control group (P 0.05). On the first day after operation, lg G, LG A, LG M, CD 4, CD8 and CD4 / CD8 in the three groups were lower than those before operation (P 0.05). There was no significant difference in immunological indexes between omega-3 PUFA Gln group and preoperative group on the 7th day after operation (P 0.05). On the 7th day after operation, some immunological indexes in Gin group and control group were still lower than those before operation (P 0.05). There was significant difference in the incidence of postoperative complications between co-3 PUFA Gln group and control group (蠂 2 鈮，
本文编号：2479316
[Abstract]:Aim: to study the effect of glutamine combined with omega-3 polysaturated fatty acid (omega-3 polyunsaturated fatty acid,PUFA) parenteral nutrition support on postoperative nutritional status and immune function in patients with colorectal cancer. Methods: 96 patients undergoing radical resection of colorectal cancer were randomly divided into glutamine combined with omega-3 polysaturated fatty acid parenteral nutrition (omega-3 PUFA Gln) group). Glutamine fortified parenteral nutrition (Gin) group and routine parenteral nutrition group (control) group, 32 cases in each group. The patients in the three groups received equal nitrogen and equal calorie nutritional support for at least 7 days from the end of the operation. The experimental group was treated with glutamine injection and omega-3 polysaturated fatty acid injection intravenously. Then, the peripheral blood T lymphocyte subsets (CD4) of (BW), albumin (ALB), hemoglobin (HGB), prealbumin (TF), transferrin (PA), were measured and compared before operation, on the first day after operation and on the 7th day after operation. CD8, CD4 / CD8 and IgG,IgM,IgA, were used to compare the incidence of postoperative complications and hospital stay in the three groups. The statistical analysis was carried out by using SAS 9.2 statistical software, and the P value was less than 0.05. it was statistically significant. Results: hemoglobin, serum albumin, prealbumin and transferable protein in the three groups were lower than those before operation on the 1st and 7th day after operation (P 0.05). On the 7th day after operation, the level of serum prealbumin in omega-3 PUFA Gln group was higher than that in Gin group and control group (P 0.05). On the first day after operation, lg G, LG A, LG M, CD 4, CD8 and CD4 / CD8 in the three groups were lower than those before operation (P 0.05). There was no significant difference in immunological indexes between omega-3 PUFA Gln group and preoperative group on the 7th day after operation (P 0.05). On the 7th day after operation, some immunological indexes in Gin group and control group were still lower than those before operation (P 0.05). There was significant difference in the incidence of postoperative complications between co-3 PUFA Gln group and control group (蠂 2 鈮，
本文编号：2479316
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