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目的探讨谷氨酰胺在大肠癌患者术后联合胃肠道外营养(TPN)对术后恢复的影响。方法 60例大肠癌患者随机分为实验组(肠外营养加谷氨酰胺)和对照组(常规肠外营养),观察术后恢复的一般情况、蛋白质代谢和氮平衡以及细胞免疫功能情况。结果两组术后血浆清蛋白和氮摄入量与术前第4天比较明显降低,差异有统计学意义(P<0·01),术后第7天,实验组血浆清蛋白和氮摄入量明显高于对照组,差异有统计学意义(P<0·05)。两组术后TLC、CD3+、CD4+、CD8+比术前第4天有明显下降,手术前后相比均明显的差异(P<0·01),实验组手术后第7天的TLC、CD3+、CD4+、CD8+明显高于对照组(P<0·05)。结论大肠癌患者术后予以肠外营养联合谷氨酰胺治疗,比常规肠外营养更有利于术后负氮平衡的改善及血桨白蛋白的恢复,并对患者免疫力有较大的提高,加速患者术后各方面的恢复。
Objective To investigate the effect of glutamine on postoperative recovery of patients with colorectal cancer combined with parenteral nutrition (TPN). Methods Sixty patients with colorectal cancer were randomly divided into experimental group (parenteral nutrition plus glutamine) and control group (routine parenteral nutrition). The general situation of postoperative recovery, protein metabolism, nitrogen balance and cellular immune function were observed. Results The postoperative plasma albumin and nitrogen intake of the two groups were significantly lower than those of the fourth day before operation, the difference was statistically significant (P <0.01). On the seventh postoperative day, the albumin and nitrogen of the experimental group Intake was significantly higher than the control group, the difference was statistically significant (P <0. 05). The levels of TLC, CD3 +, CD4 + and CD8 + in the two groups after operation were significantly lower than those of the preoperative day 4 and significant difference before and after operation (P <0.01) , CD8 + was significantly higher than the control group (P <0.05). Conclusion The patients with colorectal cancer were treated with parenteral nutrition combined with glutamine, which is more conducive to the improvement of negative nitrogen balance and the recovery of serum albumin than routine parenteral nutrition, and greatly improved the patient’s immunity. Accelerate the recovery of patients in all aspects.