Effects Of Glutamine And Omega-3 Polyunsaturated Fatty Acid Parenteral Nutrition On Postoperative Nutritional Status And Immune Function In Colorectal Cancer Patients

Objective: To investigate the effect of glutamine and omega-3 polyunsaturated fatty acid(omega-3 PUFA) parenteral nutrition on nutritional status and immune function in patients with colorectal cancer. Methods:Ninety-six patients undergoing elective radical mastectomy were randomly divided into omega-3 PUFA+Gln group,Gln group and routine parenteral nutrition group, each group of 32 patients.After surgery,each group receive equal nitrogen and isocaloric nutritionalsupport at least 7 days ,meanwhile,omega-3 PUFA+Gln group was given glutamine and omega-3 PUFA supplementation intravenously, Gln group was given glutaminesupplementation intravenously.Then,the levels of serum hemoglobin,albumin,prealbumin,transferring, lgG,lgA,lgM,CD4+, CD8+,CD4+/CD8+ were measured before operation, first day after operation and seventh days after operation and were compared simultaneously. The incidence ofcomplications and postoperative hospital stay also were compared in three groups.Data was analyzed with SAS 9.2 software, P <0.05 indicating statistical significance.Results:In comparison with preoperative levels,the levels of serum hemoglobin,albumin,prealbumin and transferring in the three groups were decreasedat first day after operation and seventh days after operation (P <0.05), and the serum prealbumin level in omega-3 PUFA + Gln group was higher than that in Gln groupand in control group (P<0.05). At first dayafter operation,the levels of lgG, lgA, lgM, CD4+,CD8+, CD4+/CD8 + in the three groups were lower than those before operation(P<0.05).There was no significant difference in the immunological parameters of omega-3 PUFA + Gln group at seventh days after operation compared to those before operation (P >0.05). Some immunological parameters of Glngroup and control group were not raise again significantly.There was statistically significant difference in the total incidence of postoperative complications between omega-3 PUFA + Gln group and control group( ?2=14.930, P < 0.05). There was statistically significant difference between omega-3 PUFA+ Gln group and control group (?2 =8.772, P < 0.05).There was no significant difference in the total incidence of postoperative complications between Gln group and control group(?2 =0.933,P > 0.05) .Postoperative hospital stay was (9.8±3.1) d in omega-3 PUFA plus Gln group,(9.5 ± 2.9) d in Gln group and (12.2±3.9) d in control group, respectively.There was significant difference between omega-3 PUFA plus Gln group and control group (t0.05/2,31=4.758,P < 0.001). There was significant difference between Gln group and control group (t0.05/2,31=4.860,P < 0.001). There was no significant difference between omega-3 PUFA plus Gln group and Gln group (t0.05/2,31=0.292, P=0.771).Conclusion: The combination of omega-3 PUFA and Gln improves the immune function andnutritional status of postoperative patients with colorectal cancer.And,such supplemented formula reduces the rate of postoperative complications and length of hospital stay.