Effects Of Glutamine-Supplemented Total Parenteral Nutrition On The Postoperative Patients With Colorectal Carcinoma

Objective: To evaluate the effects of glutamine-supplemented total parenteralnutrition on nutritional status, immune function of patients with colorectal carcinoma onthe postoperative patients with a course of chemotherapy before operation. Methods: 60patients with colorectal carcinoma randomized into three groups, the standard TPN groupand glutamine-suppiemented TPN group was given an isocaloric (25kcal·kg^-1·d^-1)andisonitrogenous (0.20g·kg^-1·d^-1)total parenteral nutrition for 6 days after operationtogether with a course of chemotherapy before operation lasting 3 days. The 25％～35ï¼…of nitrogenous source of glutamine-supplemented TPN group was supplied by glutaminedipeptiven, others and the nitrogenous source of standard TPN group was supplied bynovamin. The routine group was treated by routine program. All variables were measuredon anterioperation and postoperative day 6. Nutritional Status was determined by bodyweight, triceps skinfold thickness, arm muscle circumference, plasm concentrations ofalbumin, prealbumin, transferin, immune function by total lymphocyte count,percentage of CD3⁺ cell, CD4⁺ cell, CD8⁺ cell and NK cell. Results: No seriouscomplications occurred in any groups during the trial. Body weight, triceps skinfoldthickness, arm muscle circumference, plasm concentrations of prealbumin, transferin,nitrogen balance, percent of CD3⁺ cell, CD8⁺ cell decreased in three groups afteroperation, no significant difference was showed among them. Body weight of the routinegroup losed most. On operative day 6, the arm muscle circumference ofglutamine-supplemented TPN group decreased least in the three groups, but thepercentage of CD4⁺ cell and NK cell, the ratio of CD4⁺/CD8⁺ of group B was the highestin the three group, the concentration of albumin and total lymphocyte count ofglutamine-supplemented TPN group was higher than in standard TPN group. Conclusion:glutamine-supplemented TPN is beneficial to alleviating the state of catabolism caused bychemotherapy and operation. It can decrease the loss of muscle and fat tissue, promotesynthesis of protein. It can improve the nutritional contion.By raising total lymphocytecount, the percentage of CD4⁺ cell, NK cell and the ratio of CD4⁺/CD8⁺, it can alsomodulate post surgical immunosuppressive state.