De Luis D A, Izaola O, Cuellar L, Terroba M C, Martin T, Aller R
Institute of Endocrinology and Nutrition, Medicine School and Hospital Rio Hortega, Valladolid, Spain.
Eur Rev Med Pharmacol Sci. 2009 Jul-Aug;13(4):279-83.
Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using a higher dose of arginine (20 g per day) could improve nutritional variables.
A population of 72 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: a) patients were receiving an enteral diet supplements with arginine and fiber (group I); b) patients were receiving an isocaloric, isonitrogenous enteral formula (group II).
No significant intergroup differences in the trend of the three serum proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (7.89% group I and 5.88% group II: ns). The postoperative infections complications were similar in both groups (23.6% group I and 20.6% group II: ns). Fistula was less frequent in enriched nutrition group (5.2% group I and 17.6% group II: p = 0.026). The length of postoperative stay was better 24.3 +/- 14 days in the immunonutrition group than 36.1 +/- 27 days in the control group (p = 0.036).
Enriched formula improves local wound complications in postoperative head and neck cancer patients and decreases length of stay.
接受手术的头颈癌患者术后并发症发生率较高。我们研究的目的是调查头颈癌患者术后使用更高剂量精氨酸（每天20克）进行营养支持是否能改善营养指标。
纳入72例口腔和喉癌患者。手术时，患者被随机分为两组：a）患者接受含精氨酸和纤维的肠内营养补充剂（第一组）；b）患者接受等热量、等氮量的肠内配方制剂（第二组）。
未检测到两组间三种血清蛋白和淋巴细胞变化趋势的显著差异。两种配方制剂的胃肠道耐受性（腹泻情况）良好（第一组为7.89%，第二组为5.88%：无显著性差异）。两组术后感染并发症相似（第一组为23.6%，第二组为20.6%：无显著性差异）。营养强化组的瘘管发生率较低（第一组为5.2%，第二组为17.6%：p = 0.026）。免疫营养组术后住院时间为24.3±14天，优于对照组的36.1±27天（p = 0.036）。
营养强化配方制剂可改善头颈癌患者术后局部伤口并发症并缩短住院时间。
