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目的评价添加丙氨酰-谷氨酰胺双肽(Ala-Gln)的肠外营养(PN)对贲门癌根治术后病人的治疗作用。方法将贲门癌根治术后病人80例随机分为研究组(Ala-Gln强化的PN)及对照组(常规PN),每组40例。术后第1~7 d予以营养支持治疗,比较两组病人的体重变化、术后平均住院日,并测定血浆谷氨酰胺(Gln)、血浆白蛋白、血清内毒素水平。结果手术前后,研究组体重无明显变化,对照组体重平均下降(4.8±2.5)kg;研究组术后平均住院日为(10.5±3.1)d,与对照组(15.2±2.4)d比较差异显著(P<0.01);术后研究组血浆Gln水平下降不明显,而对照组显著下降,二者差异显著(P<0.01);研究组术后7 d血浆白蛋白浓度明显回升(39.76±4.32)g/L,与对照组(32.87±3.85)g/L比较,有显著性差异(P<0.01);研究组术后血清内毒素水平增加不明显,而对照组明显增加,两者差异显著(P<0.01)。结论Ala-Gln强化的PN能显著提高贲门癌根治术后病人的血浆Gln水平,有效改善手术导致的负氮平衡,提高血浆白蛋白水平,保护肠黏膜屏障,减轻高内毒素血症,改善预后,促进病人的康复。
Objective To evaluate the therapeutic effect of parenteral nutrition (Ala-Gln) supplemented with alanyl-glutamine on patients after radical resection of cardiac cancer. Methods Eighty patients after radical resection of cardia cancer were randomly divided into study group (Ala-Gln-enhanced PN) and control group (conventional PN), 40 cases in each group. Nutritional support was given on the 1st to 7th postoperative days. The body weight and postoperative average length of stay were compared between the two groups. Plasma glutamine (Gln), serum albumin and serum endotoxin levels were also measured. Results Before and after the operation, the body weight of the study group had no significant change. The body weight of the control group decreased by an average of 4.8 ± 2.5 kg. The average postoperative hospital stay was (10.5 ± 3.1) days in the study group, which was significantly different from that in the control group (15.2 ± 2.4) days (P <0.01). The level of plasma Gln in the study group was not significantly decreased (P <0.01), while the level in the control group was significantly lower (P <0.01) g / L, compared with the control group (32.87 ± 3.85) g / L, there was a significant difference (P <0.01); the study group postoperative serum endotoxin levels did not increase significantly, while the control group was significantly increased, the difference was significant P <0.01). CONCLUSIONS: Ala-Gln-enriched PN can significantly increase the level of plasma Gln in patients with gastric cardia cancer after radical resection, effectively improve the negative nitrogen balance caused by surgery, raise the level of plasma albumin, protect the intestinal mucosal barrier, reduce the high endotoxemia and improve the prognosis , To promote the patient’s recovery.