摘要
目的 观察不同碳链脂肪乳剂对肝脏外科患者脂肪及肝脏能量代谢的影响。方法选取2014年12月~2016年4月医院收治肝脏外科患者60例,采用随机数字法分为对照组(n=30)和观察组(n=30)。两组均给予肠外营养支持,对照组采用脂肪乳剂为20%英脱利匹特治疗,观察组采用20%力保肪宁治疗,在治疗前后采用脂肪廓清试验检测血浆、尿液中的肉毒碱及动脉血酮体浓度及其比例变化,比较不同碳链脂肪乳剂对肝脏外科患者脂肪及肝脏能量代谢的影响。结果两组术前甘油三酯清除率及甘油三酯半衰期比较,差异无统计学意义(P>0.05);两组术后甘油三酯清除率及甘油三酯半衰期均有所变化,但是观察组甘油三酯清除率及甘油三酯半衰期波动更小(P<0.05);两组术前亚油酸及亚麻酸含量清除率比较,差异无统计学意义(P>0.05);两组术后亚油酸及亚麻酸含量清除率均有所提高,但是观察组上升幅度小于对照组(P<0.05);两组术前肝脏能量代谢水平比较,差异无统计学意义(P>0.05);观察组术后肝脏能量代谢水平波动幅度小于对照组(P<0.05)。结论肝脏外科患者采用20%力保肪宁肠外营养支持效果理想,值得推广应用。
Objective To observe the effects of fat emulsions with different carbon chains on fat metabolism and liver energy metabolism in the patients in liver surgery. Methods A total of 60 patients who were admitted to the department of liver surgery in our hospital from December 2014 to April 2016 were collected. They were divided into the control group （n=30） and the observation group （n=30） by random number method. Both groups were given parenteral nutrition support. The control group was given fat emulsion combined with 20% intralipid. The observation group was given 20% lipofundin. Before and after the treatment, fat clearance test was adopted. The changes of the concentration and ratio of carnitine and arterial blood ketone in the blood and urine were measured. The effects of fat emulsions with different carbon chains on fat metabolism and liver energy metabolism were compared. Results There was no statistically signifi- cant difference in triglyceride clearance rate and triglyceride half-life period between the two groups before the surgery （P〉0.05）; the triglyceride clearance rate and triglyceride half-life period of the two groups were all changed after the surgery, hut the fluctuations of triglyceride clearance rate and triglyceride half-fife period was less in the observation group（P〈0.05）; there was no statistically significant difference in the clearance rate of linoleic acid and linolenic acid between the two groups before the surgery（P〉0.05）; the clearance rate of linoleie acid and linolenic acid in both groups was improved, but the increase in the observation group was less than that in the control group（P〈0.05）; there was no statistically significant difference in liver energy metabolism between the two groups before the surgery（P〉0.05）; the fluctuations of liver energy metabolism level in the observation group was less than that in the control group after the surgery（P〈0.05）. Conclusion The effect of parenteral nutrition support of 20% lipofundin the patients
作者
曾国祥
邬善敏
熊娟
ZENG Guoxiang WU Shanmin XIONG Juan(Department of No.1 General Surgery, Hanchuan People＇s Hospital in Hubei Province, Hanchuan 431600, China Department of Hepatobiliary-pancreatic-splenic Surgery, the People＇s Hospital of Wuhan University, Wuhan 430060, China Clinical Laboratory, Hanchuan People＇s Hospital in Hubei Province, Hanchuan 431600, China)
出处
《中国现代医生》
2017年第4期10-12,15,共4页
China Modern Doctor
基金
湖北省武汉市科技局医院重点专学科建设及公共事业计划项目(201161038342-02)
关键词
不同碳链脂肪乳剂
肝脏外科
肝脏能量代谢
保护作用
Fat emulsions with different carbon chains
Liver surgery
Liver energy metabolism
Protective effects
