Early Postoperative Feeding Could Partially Replete Plasma Glutamine and Arginine Following Resection of Colorectal Cancer

本研究的目的為（1）評估外科手術抑壓對血漿中麩胺酸及鮭卵酸的改變。（2）比較早期灌食對於麩胺酸及鮭卵酸恢復的效果。接受大腸切除來治療大腸癌的一百四十位患者分為四組。第一組患者手術後禁食六天。第二、三、四組患者從手術後第二日至第六日分別由鼻胃管給予低渣、高脂肪或含麩胺酸的配方灌食。第五、六、七組患者則以鼻空腸管由第二日至第六日灌食了上述的三種配方。所有患者在手術前，手術後第一日及第六日測量了血漿中的麩胺酸及鮭卵酸。手術後，血漿中的麩胺酸及鮭卵酸在所有的患者均下降。很意外的在禁食組第六天時的血漿中的麩胺酸及鮭卵酸比手術前的數值來的高。而且在早期灌食的患者，灌食可以部分恢復血中的麩胺酸及鮭卵酸。這一研究顯示手術後血漿中的麩胺酸及鮭卵酸會下降，但禁食可能可以動員身體內儲藏的麩胺酸及鮭卵酸。早期灌食至少可以部分恢復血漿中的麩胺酸及鮭卵酸。

關鍵字

麩胺酸；鮭卵酸；鼻胃灌食；鼻空腸灌食

並列摘要

The purpose of the study are: (1) To assess the relative changes of plasma glutamine and arginine levels following surgical stress, and (2) to compare the effects of early feeding methods on the restoration of glutamine and arginine.One hundred and forty patients underwent colon resection for cancer entered the study. Group I patients were kept on nothing per os (NPO) for 6 days. Group II, III, IV were fed through a nasogastric (NG) tubes, and group V, VI, VII were fed through a nasojejunal (NJ) tubes from the second to the sixth postoperative day (POD) with low residual, high-fat and glutamine-containing enteral formulas. The patients had measurement of plasma glutamine and arginine preoperatively, on the first and the sixth postoperative day.Both plasma glutamine and arginine decreased following surgery in all groups of patients. Glutamine and arginine were surprisingly higher than the preoperative level on the sixth POD in NPO group. Glutamine and arginine were relatively restored with early tube feeding.In conclusion, the study suggested that plasma glutamine and arginine were decreased following surgery, but starvation will probably mobilize the glutamine and arginine reserve in the body. Early feeding could at least partially replete glutamine and arginine.

並列關鍵字

Glutamine ； Arginine ； Nasogastric feeding ； Nasojejunal feeding

國際替代計量

Early Postoperative Feeding Could Partially Replete Plasma Glutamine and Arginine Following Resection of Colorectal Cancer

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