摘要
作者将恶性梗阻性黄疸患者１３例，随机分为长链脂肪乳（ＬＣＴ，Ａ组）和中长链脂肪乳（ＭＣＴ／ＬＣＴ，Ｂ组）两组，围手术期给予不同脂肪乳剂（ＬＣＴ、ＭＣＴ／ＬＣＴ）的营养支持（ＰＮ）１０日。结果显示：ＭＣＴ组术后及ＰＮ期间血ＣＨ、ＴＧ及ＬＤＬ逐渐下降，ＨＤＬ升高，Ｐ＜０．０５。两组血胆红素于引流术后明显下降，ＩＢｉｌ在ＭＣＴ组下降更为明显，术后６天已达正常，且与ＬＣＴ组比较Ｐ＜０．０１。两组血糖、肝酶、血浆蛋白与氮平衡变化趋势相同，手术前、后合并血糖升高，需补充适量胰岛素；引流后肝酶逐渐下降，ＰＡＢ、ＴＲＦ于ＰＮ期间逐渐升高，术后负氮平衡于术后４天后得到纠正。结论：梗阻性黄疸引流术后双能源ＰＮ支持１０日，含ＭＣＴ脂肪乳剂对血脂代谢及胆红素生成影响更小，并达到与ＬＣＴ同样的节氮效应。
Abstract Thirteen patients with malignant obstructive jaundice were randomly divided into two groups to receive parenteral nutrition with LCT or MCT/LCT emulsion in their postoperative period. Plasma concentration of TG,Ch, lipoprotein, bilirutin, probein, nitrogen balance and ALT, AST,AKP, γ-GT were measured before and after 10 days nutrition support. Compared with the LCT group, plasma concentration of TG, Ch, LDL decreased,while HDL increased in the MCT group. Bilirubin went down after operation in all patients but significantly lower IBil level was found in the MCT group, and blood glucose level was higher in both groups. No significant changes were found in the difference of enzymes ,plasma protein and nitrogen balance between the two groups. It is concluded that the fat emulsion containing MCT has less effect on lipid metabolism and bilirubin production,therefore , it is probably preferable to implement nutrition support for the patients with obstructive jaundice.
出处
《普外临床》
CSCD
1996年第4期226-229,共4页
