摘要
目的 本研究以胃癌根治术后病人为对象，在限制非蛋白热卡和氮源的条件下，观察雷尼替丁对术后应激反应和蛋白质代谢的影响。 方法 将３０ 例因胃癌行根治术的病人，随机分为雷尼替丁组（ｎ＝１５）和对照组（ｎ＝１５） 两组，雷尼替丁组给予雷尼替丁１００ ｍｇｉｍ ｑ１２ｈ；对照组不使用雷尼替丁或西咪替丁等类似药物。两组病人均于术后第１ 日晨开始自周围静脉给予低热卡静脉营养支持３ 天（ 非蛋白热卡：７５－６ ｋＪ·ｋｇ－１·ｄ－１；氮量：０－０８ ｇ·ｋｇ－ １·ｄ－ １） ，并监测体温、肝功能、白／球蛋白、血糖、皮质醇、尿儿茶酚胺及香草基苦杏仁酸的水平和氮平衡变化。 结果 两组相比，雷尼替丁组每日负氮平衡现象均明显改善，其中术后第１ 天与术后第３ 天有显著性差异，术后３ 天的累积氮平衡差别显著（ －２２±１０ ｖｓ． －３７±１６ ｇ，Ｐ＜ ０－０５） ；连续应用雷尼替丁３ 天，血皮质醇浓度显著降低（１７ ±５ ｖｓ．２４±９ μｇ／Ｌ，Ｐ＜０－０５）；两组病人体温、肝功能、白／球蛋白、血糖、尿儿茶酚胺及香草基苦杏仁酸变化无明显差异。 结论 在低热卡静脉营养支持下，雷尼替丁对因胃癌行根治术病人术后可改善负氮平衡现象；连续应用３
Objective The effect of ranitidine administration on the stress response and protein catabolism was assessed in gastric cancer patients undergoing subtotal gastrectomy. Methods Thirty patients were divided into 2 groups randomly (Ranitidine group, n =15; Control group, n =15). Hypo caloric parenteral nutrition with limited nitrogen resource was given to both groups. In ranitidine group, 100 mg of ranitidine was administered intramuscularly q12h for 3 days postoperatively.Body temperature, hepatic function, albumin/globulin and blood glucose levels were measured pre and post operatively. The concentration of plasma cortisol, urinary catecholamine and vanillyl mandelic acid, and the postoperative nitrogen balance were monitored. Results Ranitidine does not influence the postoperative increase in body temperature, alanine aminotransferase and blood glucose levels and the postoperative decrease of albumin. Plasma cortisol levels in ranitidine group was statistically lower on postoperative days 4 than in control group (17±5 vs. 24±9 μg/L, P <0 05). The postoperative increase in urinary catacholamine and vanillyl mandelic acid level in both groups were basically the same. The cumulative urinary nitrogen balance in 3 postoperative days in ranitidine group were significantly improved (-22±10 vs. -37±16 g, P <0 05). Conclusion Ranitidine administration results in significant decrease of plasma cortisol level,a decrease of the protein catabolism,and improvement of the nitrogen balance.
出处
《中华普通外科杂志》
CSCD
1999年第6期452-454,共3页
Chinese Journal of General Surgery
