將32例肝臟外科患者(原發性肝細胞肝癌16例,肝硬變門脈高壓8例,阻塞性黃疸8例)隨機分為:Ⅰ組(對照組,n=10,僅給葡萄糖及氨基酸)、Ⅱ組[低脂組,n=11,脂肪乳劑用量為1g/(kg·d)]和Ⅲ組[高脂組,n=11,脂肪乳劑用量為2g/(kg·d)],術后按組別給予TPN支持,并分別測定術前1天、術后第1和6天肝功、糖代謝和脂代謝各項指標。結果:①Ⅱ、Ⅲ組術后第6天肝臟酶學指標明顯下降(P<0.05),Ⅰ組仍高于術前;②Ⅱ、Ⅲ組術后糖代謝迅速恢復正常,而Ⅰ組出現高血糖及高胰島素血癥;③Ⅱ組血清脂質、脂蛋白、載脂蛋白水平及卵磷脂膽固醇酯酰轉移酶活性于術后第6天基本恢復正常(P<.05),而Ⅰ、Ⅱ組仍有異常。本結果提示:含有脂肪乳劑的TPN支持對肝臟外科患者術后的肝功恢復有益,其合理劑量為1G/(kg·d)。
引用本文:
李纓來,鄭朝旭,彭斌,劉占培,吳紅斌,湯宇,嚴律南. 脂肪乳劑對肝臟外科患者術后脂肪代謝的影響. 中國普外基礎與臨床雜志, 1996, 3(2): 96-99. doi:
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- 1. Long JM,Wilmore DW,Masson AD,et al.Effect of carbohydrate and fat on nitrogen excretion during total intravenous feeding.Ann Surg,1997;185:417.
- 2. Naber AH.Total parenteral nutrition :practical recommendations and new developments.Scand J Gastroenteral,1991;26:118.
- 3. Haupt W,Postoperative parenteral nutrition following segmental liver resection.Infusions Therapie,1990;17:94.
- 4. Nagayama W.Fat emulsion in surgical patients with liver disorders. J Surg Res,1989;47:59.
- 5. 都春基,大柳治正,宇佐美真,他.硬變肝切除前后の脂質代謝に關するs實驗的研究.外科と代謝營?養p99,1991;25(5):459.
- 6. 嚴律南.肝臟能量代謝與創傷反應.普外臨床,1993;8(2):107.