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）和中／长链脂肪乳剂组（ｎ＝１３，简称ＭＣＴ组）。ＬＣＴ组脂肪乳剂为２０％Ｉｎｔｒａｌｉｐｉｄ，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ＰＯＤ１明显升高，但ＭＣＴ组随后显著下降，ＬＣＴ组下降速度慢于ＭＣＴ组，Ｐ＜００５。ＰＮ期间血脂代谢无异常；ＣＮＴ术后明显升高，尿排出减少，ＰＯＤ７时，ＬＣＴ组血ＣＮＴ高于ＭＣＴ组，尿ＣＮＴ低于ＭＣＴ组，Ｐ＜００５；血皮质醇、胰岛素（Ｉ）、胰高糖素（Ｇ）以及Ｇ／Ｉ术后第１天均明显升高，随后逐渐下降，而ＬＣＴ组ＰＯＤ７时，胰高糖素（Ｇ）以及Ｇ／Ｉ维持在较高水平。血糖术后明显升高，ＰＯＤ４，７时，ＬＣＴ组持续在较高水平，ＭＣＴ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 the surgical patients with liver disease.Methods:Twenty-five patients with liver disease were randomly assigned to two PN groups:LCT group(n=12)and MC/LCT group(n=13).Fat energy in group LCT was supplied by 20%-Intralipid,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(CNT)in serum and urine,and hormone were tested at the pre-OP、POD1、4、7d.Results:There were no harmful to live function and fat metabolism in group MCT/LCT.There is less influence on the biliburbin metabolism and less need of CNT in lipofundin as compared with intralipid.Serum cortisol、insulin(I)、glucagon(G)and G/I markedly increased postoperation,and in LCT group the glucose、glucagon and G/I maintained higher level as compared with MCT group at POD4,7 during the trial.Conclusion:Those results indicated Lipofundin was an ideal energy source for the cirrhotic patient,specially for hyperbilirubinemia.Such infomation is important to guide and enlarge clinical practice. \ \
出处
《中国实用外科杂志》
CSCD
北大核心
1998年第12期742-745,共4页
Chinese Journal of Practical Surgery
关键词
中链脂肪乳剂
长链脂肪乳剂
肝脏外科
Medium chain triglyceride Long chain triglyceride Liver surgery
