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目的 探讨胃肠癌根治术后应用精氨酸强化低热量肠外营养的营养、免疫作用及其对术后疲劳的影响。方法 40 8例胃肠癌根治术后病人分为 3组 ,术后第 1天开始分别给予 3种不同方案的肠外营养支持 5～ 7天。其中低热量肠外营养组 (HPN组 ) 3 5 2例 ,精氨酸强化低热量肠外营养组 (Arg组 )组 3 0例 ,对照组 2 6例。术前及术后第 8天检测多项营养和免疫指标 ,并评估病人手术前后的疲劳程度。结果 胃肠癌根治术后HPN具有明显的营养效应。精氨酸强化HPN改善了病人的营养与免疫状况 ,使术后感染率从 2 3 %降低至 10 % ,并改善了术后疲劳程度 (P <0 0 5 )。结论 精氨酸强化HPN既有明显的营养作用 ,又有免疫调节作用 ,并能改善胃肠癌根治术后病人的疲劳程度
Objective To investigate the nutritional and immunological effects of arginine-fortified low-calorie parenteral nutrition after radical operation of gastrointestinal cancer and its effect on post-operative fatigue. Methods Forty eight patients with radical resection of gastrointestinal cancer were divided into three groups. Three different protocols of parenteral nutrition were given on the first day after operation for 5-7 days. There were 352 cases in HPN group, 30 cases in Arg group and 26 cases in control group. Preoperative and postoperative eight days to detect a number of nutritional and immune indicators, and assess the patient’s fatigue before and after surgery. Results HPN had a significant nutritional effect after radical operation of gastrointestinal cancer. Arginine-fortified HPN improved the patient’s nutrition and immune status, reducing the postoperative infection rate from 23% to 10% and improving postoperative fatigue (P <0.05). Conclusion Arginine-fortified HPN has both obvious nutritional effects and immunomodulatory effects, and can improve the patient’s fatigue after radical operation of gastrointestinal cancer