Clinical Application Of Glutamine Enhanced Hypo-nitrogen Hypo-caloirc Parenteral Nutrition In Postoperative Stress Period For Gastric Cancer Patients With Nutritional Risk

Objective: This study was to explore the clinical application of hypo-nitrogenhypo-caloric parenteral nutrition (HNHC) for postoperative supplement in gastriccancer patients of nutritional risk in comparison with the classical total parenteralnutrition regimen (TPN). We also studied the clinical significance of glutamineenhanced hypo-nitrogen hypo-caloric parenteral nutrition (GEHN). Methods: The89cases gastric cancer patients with NRS-2002score (3~5) were randomly distributed into3groups. The postoperative nutrition support was given by TPN, HNHC and GEHNstrategies for6days. The blood-glucose, nutritional markers, as well as immunologicalmarkers were monitored. Postoperative recovery processes and complications werecompared among the three groups. Results:(1). HNHC group gained betterblood-glucose control comparing to TPN group. Statistically significant differenceswere shown on postoperative day1,2and3.(2). All patients from the3groups showednegative nitrogen balance after operation. There was no statistically significantdifference between TPN and HNHC groups. GEHN group showed a lesser decrease ofTRF than in HNHC group from preoperative day1to postoperative day3. Therecoveries of the4nutritional markers detected were significantly more satisfying inGEHN group than that of HNHC group.(3). There was no difference between TPN andHNHC groups by immunological markers examined. Immune function restorationtended to be more rapidly in GEHN group, especially, the recovery of CD3wassignificantly faster.(4).The SIRS was more frequent in TPN group. Intestinal peristalsisrecovery was significantly faster in GEHN group than HNHC group. Conclusions:Compared with TPN, HNHC was safe and applicable in gastric cancer patients withnutritional risk for short time support after surgery. HNHC support had betterblood-glucose control and fewer SIRS. GEHN could effectively improve thepostoperative nitrogen balance and immune restoration; shorten the recovery of bowelmovement. GEHN is worthy of a parenteral nutrition support regimen in the postoperative stress period.