胃肠道肿瘤手术患者术中输注支链氨基酸

Intraoperative infusion of branched-chain amino acids in patients undergoing gastrointestinal tumor surgery.

作者信息

Wu Qiwei, Zhang Yanying, Yang Yan, Ge Shengjin, Xue Zhanggang

机构信息

Department of Anaesthesia, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.

Department of Anaesthesiology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

出版信息

World J Surg Oncol. 2015 Dec 15;13:336. doi: 10.1186/s12957-015-0751-y.

DOI:10.1186/s12957-015-0751-y

PMID:26666738

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4678463/

Abstract

BACKGROUND

The purpose of this study is to investigate the effects of intraoperative infusion of branched-chain amino acids (BCAA) in patients undergoing gastrointestinal tumor surgery.

METHODS

Sixty-one patients with gastrointestinal tumors undergoing gastrointestinal surgery were enrolled and randomly assigned to receive an intraoperative infusion of 3-compound BCAA solution (N = 20), amino acids (AA) solution (N = 21), or normal saline (NS) (N = 20). Nasopharyngeal temperature, blood glucose (BG), plasma insulin, and blood free fatty acids (FFA) concentrations were measured at 30 min before and 10 min after induction (T 0,T 1), 30 min and 2 h after skin incision (T 2,T 3), and 1 h after tracheal extubation (T 4). Intensity of shivering and pain was accessed at 1 h after extubation.

RESULTS

The temperature in the BCAA and AA group was significantly higher than that in the NS group at T 4 (P = 0.014 and 0.033). The incidence of shivering in the BCAA and AA group was significantly lower than in the NS group (P = 0.027 and 0.012). BG increased in AA group at T 3 and T 4 (P = 0.001 and 0.045). The plasma insulin concentration increased in the BCAA and AA group from T 1 to T 3. The plasma FFA concentrations in the BCAA group were lower than in the AA and NS group from T 2 to T 4.

CONCLUSIONS

Intraoperative BCAA and AA infusion alleviated postoperative hypothermia and shivering. BCAA infusion also inhibited fat mobilization, without adversely affecting blood glucose.

TRIAL REGISTRATION

ChiCTR-TRC-14004668.

摘要

背景

本研究旨在探讨胃肠道肿瘤手术患者术中输注支链氨基酸（BCAA）的效果。

方法

61例接受胃肠道手术的胃肠道肿瘤患者入组，随机分为术中输注3种复合BCAA溶液组（N = 20）、氨基酸（AA）溶液组（N = 21）或生理盐水（NS）组（N = 20）。分别于诱导前30分钟和诱导后10分钟（T0、T1）、皮肤切开后30分钟和2小时（T2、T3）以及气管拔管后1小时（T4）测量鼻咽温度、血糖（BG）、血浆胰岛素和血游离脂肪酸（FFA）浓度。拔管后1小时评估寒战和疼痛强度。

结果

T4时，BCAA组和AA组的体温显著高于NS组（P = 0.014和0.033）。BCAA组和AA组的寒战发生率显著低于NS组（P = 0.027和0.012）。AA组在T3和T4时BG升高（P = 0.001和0.045）。BCAA组和AA组的血浆胰岛素浓度从T1到T3升高。从T2到T4，BCAA组的血浆FFA浓度低于AA组和NS组。