摘要
目的研究肝脾外伤术后应用重组人生长激素(recombinedhumanGrowthHormone,rhGH)和适量的肠外营养(parenteralnutrition,PN)对患者氮平衡及营养状况的影响。方法所有入选患者术后均作锁骨下静脉穿刺留置导管,术后第1、3、7天分别检测静息能量消耗(restingenergyexpenditure,REE),根据检测值实验组给予1.0REE,对照组给予1.2REE;实验组于术后第3天给予9.0UrhGH(肌注,每晚1次)共7d。结果术后第3天两组患者血浆蛋白均明显下降,与术前比较,差异有显著性(P<0.01);但术后第7天实验组血浆白蛋白浓度明显回升至(34.27±3.26)g/L而对照组仅回升至(31.92±3.01)g/L,两者比较,差异有显著性(P<0.05),两组术后1周内累计氮平衡均为负氮平衡,实验组为(-138.96±21.3)mg/kg体重,对照组为(-181.33±121.3)mg/kg体重,两组差异有显著性(P<0.05)。实验组第6和第7天开始进入正氮平衡,对照组仍处于负氮平衡状态。结论rhGH加适量的营养底物可改善负氮平衡,提高血浆白蛋白水平。
Objective To evaluate the impact of recombined human growth hormone(rhGH)c ombining with moderate parenteral nutrition (PN)in postoperative hepatic and s plenic trauma patients.Methods In this prospective,randomized and controlled clinical trial,34patients were enrolled into the study group(20patients r eceived1.0REE postoperative energy supply and9.0U rhGH per day from the3r d to7th postoperative day)and the control group(14patients received1.2RE E postoperative energy supply).Plasma albumin level,hepatic and renal functi on and nitrogen balance were monitored.Results Plasma albumin level decreased in both groups on the third postoperative day comparing with that before operati on(P<0.01),increased to(34.27±3.26)g/L in the study group wh ile to(31.92±3.01)g /L in the control group,on the7th postoperativ e day the difference was significant (P<0.05).Cumulative nitrogen balanc e were negative in both groups,but was lower in the study group(-138.9 6±21.3)mg /kg body weight than that in the control group (-181.3 3±121.3;P<0.05).Positive nitrogen balance was achieved on the6th and7th postoperative day in the study group.Conclusions Ameliorated nitrogen balance and elevated plasma albumin level were achieved after rhGH supplementa tion and moderate parenteral nutrition in postoperative hepatic and splenic trau ma patients.
出处
《中国临床营养杂志》
2002年第4期258-260,共3页
Chinese Journal of Clinical Nutrition
