谷氨酰胺增强胃肠外营养对胃癌术后化疗患者影响.docVIP

谷氨酰胺增强胃肠外营养对胃癌术后化疗患者影响[摘要] 目的:研究谷氨酰胺对胃癌术后化疗患者的影响。方法:将36例胃癌术后化疗患者随机分为对照组和实验组,对照组给予化疗和胃肠外营养,实验组在对照组的基础上,在胃肠外营养液中加入谷氨酰胺(0.4 g/kg),相同时间后,检测两组的肝功能、T细胞亚群分布及口腔炎、腹泻的发生率。结果:实验组的肝功能指标血清清蛋白、谷丙转氨酶明显优于对照组,同时CD4+细胞和CD4/CD8均较对照组显著升高,而口腔炎和腹泻的发生率明显下降。结论:胃肠外营养液中加入谷氨酰胺,对胃癌化疗患者有显著的辅助治疗作用,同时可减少化疗的副作用。 [关键词] 谷氨酰胺;胃肠外营养;胃癌;化疗 [中图分类号] R735.2[文献标识码]A [文章编号]1673-7210(2009)07(a)-112-02 Effect of Glutamine supplemented parenteral nutrition on patients with gastric cancer undergoing chemotherapy after gastrectomy CHENRong (Lunjiao Hospital of Shunde, Foshan 528308, China) [Abstract] Objective: To explore the effect of Glutamine on patients with gastric cancer undergoing chemotherapy after gastrectomy. Methods: 36 patients were randomly divided into two groups. The control group was administrated with chemotherapy and normal parenteral nutrition while the experimental group was administrated with Glutamine supplemented parenteral nutrition (0.4 g/kg) in addition to chemotherapy. Liver Function, T Lymphocyte Subtype and the side effect of chemotherapy were detected after the therapy. Results: The Glutamine supplemented group showed better results in the Liver Function index, serum albumin and alanine aminotransferase (ALT), than control group. The CD4+ cells and CD4/CD8 value were also significant higher in experimental group than in control group. Glutamine group also had a low incident of stomatitis and Diarrhea. Conclusion: Supplying the parenteral nutrition with Glutamine can improve liver and immune function in patients with gastric cancer and reduce the side effect of chemotherapy. [Key words] Glutamine; Parenteral nutrition; Gastric cancer; Chemotherapy 胃癌患者术后胃肠道功能减弱,化疗更是进一步引起恶心、呕吐、食欲不振等消化道症状,使得患者所需的营养物质难以通过摄食得到满足。胃肠外营养(parenteral nutrition)能有效补充患者所需的营养成分,对术后化疗有较好的辅助治疗作用。近来研究发现,谷氨酰胺强化的胃肠外营养对术后患者的免疫功能及蛋白质合成等有明显的促进作用[1]。为了探讨谷氨酰胺对胃癌术后化疗患者的影响,笔者对比观察了谷氨酰胺对免疫功能、蛋白合成及化疗并发症等的影响。 1 资料与方法 1.1 一般资料 选取我院2006年1月～2008年6月胃癌术后化疗患者63例,排除严重肝肾功能不全者,年龄为49～65岁,随机分为对照组和实验组,其中,对照