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目的探讨危重恶性肿瘤患者术后早期应用谷氨酰胺的临床效果。方法选取2011年1月至2012年12月间110例危重恶性肿瘤患者为研究对象,按照随机数字法分为对照组和观察组,对照组55例患者给予常规标准营养支持治疗,观察组55例患者给予谷氨酰胺支持治疗,观察两组的应用效果。结果治疗前观察组和对照组的白蛋白(ALB)、前白蛋白(PAB)和转铁蛋白(TRF)比较,差异无统计学意义(P>0.05);治疗后,对照组和观察组的PAB和TRF比较,差异有统计学意义(P<0.05)。治疗前,对照组和观察组的免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋M(IgM)比较,差异无统计学意义(P>0.05);治疗后,对照组和观察组IgG比较,差异有统计学意义(P<0.05)。治疗前,对照组和观察组的BW、APACHEⅡ评分、C反应蛋白(CRP)比较,差异无统计学意义(P>0.05);治疗后,对照组和观察组的APACHEⅡ评分、CRP比较,差异有统计学意义(P<0.05)。观察组患者的ICU住院时间和术后感染发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论对于危重恶性肿瘤患者术后早期给予谷氨酰胺,能够有效地改善患者术后的营养状况,增强患者的机体免疫力,提高临床治疗效果。
Objective To investigate the clinical effect of early application of glutamine after critically ill patients. Methods A total of 110 patients with severe malignant tumors from January 2011 to December 2012 were selected as study subjects. The patients were divided into control group and observation group according to the random number method. 55 patients in the control group were given conventional standard nutritional support therapy. 55 patients were observed in the observation group. The patient was given glutamine support treatment and the effect of the two groups was observed. Results There was no significant difference in albumin (ALB), prealbumin (PAB) and transferrin (TRF) between the observation group and the control group before treatment (P>0.05); after treatment, the control group and the observation group The difference between PAB and TRF was statistically significant (P<0.05). Before treatment, the difference of immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) in the control group and the observation group was not statistically significant (P>0.05); after treatment, the control group Compared with the observation group IgG, the difference was statistically significant (P<0.05). Before treatment, there was no significant difference in BW, APACHEII scores, and C-reactive protein (CRP) between the control group and the observation group (P>0.05). After treatment, there were differences in the APACHEII score and CRP between the control group and the observation group. Statistical significance (P<0.05). The duration of ICU stay and postoperative infection in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion Early administration of glutamine for patients with critically ill cancer can effectively improve the postoperative nutritional status, enhance the patient’s immune system, and improve clinical treatment.