丙氨酰-谷氨酰胺双肽强化肠外营养在结肠癌并肠梗阻中的应用

摘要

目的：探讨丙氨酰-谷氨酰胺双肽强化肠外营养在结肠癌合并肠梗阻治疗中的临床价值。方法：2012年2月-2014年3月收治择期行手术治疗的结肠癌合并肠梗阻患者46例，按照随机数字法分为观察组和对照组各23例，观察组分别于术前和术后接受丙氨酰-谷氨酰胺双肽强化肠外营养干预，对照组仅接受标准肠外营养干预，并对两组患者手术前后的营养学指标、术后恢复和免疫学指标进行评价。结果：营养学指标方面：术后8 d，观察组在 ALB、PAB、TF 和氮平衡方面均显著高于对照组(P＜0.05)；术后恢复方面：观察组在手术前、后体重变化值及术后排气、住院时间均显著少于对照组(P＜0.05)；免疫指标方面：术后8 d，观察组在IgA、IgG、IgM和淋巴细胞计数均高于对照组(P＜0.05)。结论：丙氨酰-谷氨酰胺双肽强化肠外营养在结肠癌合并肠梗阻治疗中应用效果显著，能有效改善患者营养学指标，提高患者免疫功能，加快恢复速度，且安全，值得临床推广。%Objective:To explore the clinical value of alanyl-glutamine enriched parenteral nutrition in the treatment of colon cancer complicated with intestinal obstruction.Methods:46 patients with colon cancer complicated with intestinal obstruction with elective operation were selected from February 2012 to March 2014.According to the random number method,they were divided into the observation group and the control group with 23 cases in each group.The observation group were given alanyl-glutamine enriched parenteral nutrition intervention.The control group were given standard intestinal parenteral nutrition intervention.We compared the nutritional index,postoperative recovery and immunology index before and after operation of the two groups.Results:Nutrition indicators:8 days after the operation,in the observation group,ALB,PAB,TF and nitrogen balance were significantly higher than those in control group (P<0.05);the postoperative recovery:in the observation group,the body weight changes before and after surgery and postoperative exhaust and postoperative hospitalization time were significantly less than those of the control group(P<0.05);immune indicators:8 days after the operation,in the observation group,IgA,IgG,IgM and lymphocyte count were higher than those of the control group(P<0.05).Conclusion:The clinical effect of alanyl-glutamine enriched parenteral nutrition in the treatment of colon cancer complicated with intestinal obstruction is significant.It can improve the nutritional index effectively, improve the immunity function of patients,and accelerate the speed of recovery.It is safe and worth the clinical promotion.