[1]王继伟,黄 勇,张 桃,等.谷氨酰胺强化的肠外营养对结直肠癌病人术后短期临床结局的影响[J].肠外与肠内营养杂志,2025,(01):7-14.[doi:DOI : 10.16151/j.1007-810x.2025.01.002]
　WANG Ji-wei,HUANG Yong,ZHANG Tao,et al.The effect of glutamine-enriched parenteral nutrition on short-termoutcomes after surgery in patients with colorectal cancer[J].PARENTERAL & ENTERAL NUTRITION,2025,(01):7-14.[doi:DOI : 10.16151/j.1007-810x.2025.01.002]
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谷氨酰胺强化的肠外营养对结直肠癌病人术后短期临床结局的影响()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2025年01期
页码:
7-14
栏目:
论著
出版日期:
2025-04-02

文章信息/Info

Title:
The effect of glutamine-enriched parenteral nutrition on short-termoutcomes after surgery in patients with colorectal cancer
作者:
王继伟; 黄 勇; 张 桃; 王麦建; 郑兴斌; 谢 铭
遵义医科大学附属医院消化病医院普通外科，贵州遵义 563000
Author(s):
WANG Ji-wei;  HUANG Yong;  ZHANG Tao;  WANG Mai-jian;  ZHENG Xin-bin;  XIE Ming
Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi MedicalUniversity, Zunyi 563000,Guizhou, China
关键词:
谷氨酰胺 ; 肠外营养 ; 结直肠癌 ; 术后并发症 ; 免疫功能
Keywords:
Glutamine;  Parenteral nutrition;  Colorectal cancer;  Postoperative complications;  Immune function
分类号:
R605
DOI:
DOI : 10.16151/j.1007-810x.2025.01.002
文献标志码:
A
摘要:
目的：探讨谷氨酰胺强化的肠外营养对比普通营养支持对结直肠癌术后肠内营养不耐受病人短期临床结局的影响。 方法：采用回顾性队列研究方法，收集遵义医科大学附属医院胃肠外科 2019 年 1 月至2021年12 月接受结直肠癌根治术病人的临床资料；统计分析两组病人术后并发症发生率、围术期营养指标及炎性因子的差异。 结果：将178例病人根据肠外营养中是否添加谷氨酰胺分为对照组（普通营养治疗，n = 120）和观察组（谷氨酰胺强化的营养治疗，n = 58）。对照组与观察组术后Clavien-Dindo分级≥Ⅲ级并发症发生率分别为14.17%（17/120）和3.45%（2/58），差异具有统计学意义（P = 0.030）。观察组术后首次排气、排便时间、进流质饮食时间较对照组恢复早，术后住院时间更短（P < 0.05）；两组的30 d再入院率无明显差异（P = 0.393）。两组病人术后的总蛋白、白蛋白、前白蛋白、中性粒细胞数目/淋巴细胞数目比值、内生肌酐清除率水平变化趋势比较，差异均无统计学意义（P >0.05）；两组病人术后的淋巴细胞数目、白细胞数目、中性粒细胞百分比、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、尿素氮水平的变化趋势存在显著差异（P < 0.05）。 结论：相较于普通营养支持，术后肠外补充谷氨酰胺可降低结直肠癌病人术后并发症发生率，促进肠道功能恢复，缩短术后住院时间，改善病人免疫功能及降低炎症水平。
Abstract:
Objective: To evaluate the effects of glutamine-enriched parenteral nutrition on short-termpostoperative outcomes compared with conventional nutritional support in colorectal cancer patients with enteralnutrition intolerance after surgery. Method: A retrospective cohort study was conducted to collect clinical data fromcolorectal cancer patients who underwent radical resection at the Department of Gastrointestinal Surgery of ZunyiMedical University Affiliated Hospital from January 2019 to December 2021. The differences in postoperativecomplication rates, perioperative nutritional indicators, and inflammatory factors between the two groups were analyzed.SPSS 29.0 software was used for statistical analysis. Result: Based on whether glutamine was added to parenteralnutrition, 178 patients were divided into a control group (conventional nutritional therapy, n = 120) and an observationgroup (glutamine enhanced nutritional therapy, n = 58). The incidence of postoperative complications (Clavien Dindograde≥III) in the control and observation groups was 14.17% (17/120) and 3.45% (2/58), respectively, with a statisticallysignificant difference (P = 0.030). The observation group recovered faster than the control group in terms of time to firstexpectoration, defecation and intake of liquid diet after surgery, and had a shorter hospital stay after surgery (P < 0.05).However, there was no significant difference in the 30-day readmission rate between the two groups (P = 0.393). Therewas no statistically significant difference in the changes in total protein, albumin, pre-albumin, neutrophil/lymphocyteratio and endogenous creatinine clearance rate between the two groups of patients after surgery (P > 0.05). There werealso significant differences in the changes in lymphocyte count, white blood cell count, neutrophil percentage, alanineaminotransferase, aspartate aminotransferase, total bilirubin, and urea nitrogen levels between the two groups of patientsafter surgery (P < 0.05). Conclusion: Compared with regular nutritional support, postoperative parenteral glutaminesupplementation can reduce the incidence of postoperative complications in colorectal cancer patients, promote recoveryof bowel function, shorten postoperative hospital stay, improve patient immune function and reduce inflammatory levels.

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备注/Memo

备注/Memo:
基金项目 ：国家自然科学基金（81960105）；贵州省科技厅基础研究基金（黔科合基础[2020]1Y301）；遵义市科技计划基金（遵市科合HZ字[2023]230）通讯作者 ：谢 铭，E-mail：zmu_xieming@163.com
更新日期/Last Update: 1900-01-01