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目的评价精氨酸(Arg)和谷氨酰胺(Gln)增强的肠外营养(PN)对胃癌病人根治术后恢复的影响方法将80例胃癌病人随机平分为Arg组、Gln组、Arg+Gln组及常规PN组(Rou组)。术后给予添加不同免疫营养素的PN 1周,观察各组免疫功能变化、胃肠道功能恢复、感染并发症、住院时间。结果术后第8天:Arg组、Gln组和Arg+Gln组均比R ou组更能改善胃癌病人术后的免疫功能,差异均有统计学意义(P〈0.05),其中,Arg+Gln组对于改善病人的细胞免疫功能与Rou组相比差异有极显著统计学意义(P〈0.01);Arg组、Gln组和Arg+Gln组CRP及TNF—α比Rou组低,差异均有统计学意义(P〈0.05);术后Arg+Glu组病人胃肠道功能恢复时间短,感染并发症少及住院时间短。结论联合Arg和Gln增强的PN比单用Arg或Gln增强的PN更能恢复胃癌病人根治术后细胞免疫功能,更能抑制其炎症反应;有利于控制感染并发症,促进术后恢复。
Objective To evaluate the effect of parenteral nutrition (PN) enhanced by arginine (Arg) and glutamine (Gin) on the recovery of gastric cancer patients after radical operation.Methods 80 patients with gastric cancer were randomly divided into Arg group, Gln group, Arg + Gln Group and conventional PN group (Rou group). Postoperative PN was given for 1 week with different immunonutrients. The changes of immune function, gastrointestinal function recovery, infection complications and hospital stay were observed. Results The postoperative day 8: Arg group, Gln group and Arg + Gln group were better than R ou group in improving the immune function of gastric cancer patients after operation, the difference was statistically significant (P <0.05), of which, Arg Gln (P <0.01). The levels of CRP and TNF-α in Arg group, Gln group and Arg + Gln group were lower than those in Rou group, with statistically significant difference (P <0.05). Patients in Arg + Glu group had shorter gastrointestinal function recovery time, fewer complications and shorter hospital stay. Conclusions The combination of Arg and Gln-enhanced PN can restore the cellular immune function and inhibit the inflammatory response of patients with gastric cancer after radical surgery with Arg or Gln-enhanced PN. It is helpful to control the infection complications and promote postoperative recovery.