摘要
目的观察两种不同碳链脂肪乳剂对肝脏外科病人术后自然病程的影响。方法选择肝脏外科病人25例，随机分为两组；长链脂肪乳剂组（n＝12，简称LCT组），中／长链脂肪乳剂组（n=13，简称MCT组）。LCT组脂肪乳剂为20％Inralipid，MCT组为20％Lipofundin，连续观察1周。在术前，术后1、4、7天测定肝功能、血脂、血及尿液中肉毒碱（CNT）以及激素的变化。结果两组对肝脏酶学无明显影响。胆红素在术后1天明显升高，但MCT组随后显著下降，LCT组下降速度慢于MCT组，P＜0．05。PN期间血脂代谢无异常。CNT术后明显升高，尿排出减少，术后7天LCT组血CNT高于MCT组，尿CNT低于MCT组，P＜0．05。血皮质醇、胰岛素（I）、G以及G／I术后第1天均明显升高，随后逐渐下降，而LCT组术后7天，胰高糖素（G）以及G／I维持在较高水平。血糖术后明显升高，术后4、7天，LCT组持续在较高水平，MCT组已属正常。结论MCT／LCT乳剂可能是肝脏外科病人更为理想的脂肪能源。
Objective To study the influence of Lipofundin vs Intralipid on surgical patients with liver diseases.Methods Twenty-five patients with liver diseases were randomly assigned to two PN groups: LCT group (n = 8 ) and MC/LCT group (n = 7). Fat energy in group LCT was supplied by 20% Intralipid while group MCT/LCT was supplied by 20% Lipofundin the PN solution was infused for 7 days.The following measurements were performed:liver function,fat and lipoprotein metabolism,carnitine in serum and urine,and hormone were tested at the pre-OP、POD1、4 、7d. Results There were no harm to liver function and fat metabolism in group MCT/LCT.There is less influence on the biliburin metabolism and less need of CNT in Lipofundin as compared with Intralipid. Serum cortisol、insulin(I)、glucagon (G) and G/I markedly increased postoperatively and in LCT group the glucose、glucagon and G/I maintained at higher levels as comared with MCT group at POD4, 7. Conclusions Those results indicated Lipofundin was an ideal energy source for the cirrhotic patients specially when there was hyperbilirubinemia.
出处
《中国临床营养杂志》
1999年第3期129-132,共4页
Chinese Journal of Clinical Nutrition
