CAJ | 학술논문

目的研究含橄榄油脂肪乳剂在食管癌术后肠外营养支持中应用的安全性和有效性.方法 60例胸段食管癌根治术患者用SPSS软件产生的随机数字分为对照组(n=30)和研究组(n=30),两组患者术后进行7～10 d的肠外营养支持,采用等氮、等热量、等渗透压、等液体量配方.研究组使用含橄榄油脂肪乳剂,对照组使用中/长链脂肪乳剂.所有患者分别于术前及术后第1天、第8天清晨空腹抽取外周静脉血送检.观测指标:术前营养状态及营养风险评估,包括体重、体重指数、营养风险筛查等;安全性指标,包括血常规、血电解质、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素、结合胆红素、尿素氮(BUN)、肌酐、血糖等;有效性指标,包括血红蛋白、白蛋白、总蛋白等.结果两组术后第8天的白蛋白及总蛋白值均在正常范围内,但研究组的测量值较对照组高(P=0.000),且研究组术后第8天与第1天的总蛋白差值较对照组高(P=0.002).术后第8天对照组的AST及BUN值升高,而研究组的AST及BUN均在正常范围且明显低于对照组(P=0.025,P=0.013).两组间在生命体征变化、不良事件发生率、血常规、血电解质、血糖、血脂等方面差异无统计学意义(P均>0.05).结论含橄榄油脂肪乳剂在食管癌术后肠外营养支持中的应用是安全有效的;相对于中/长链脂肪乳剂而言,其对AST及BUN的影响较小.
목적 연구함감람유지방유제재식관암술후장외영양지지중응용적안전성화유효성.방법 60례흉단식관암근치술환자용SPSS연건산생적수궤수자분위대조조(n=30)화연구조(n=30),량조환자술후진행7～10 d적장외영양지지,채용등담、등열량、등삼투압、등액체량배방.연구조사용함감람유지방유제,대조조사용중/장련지방유제.소유환자분별우술전급술후제1천、제8천청신공복추취외주정맥혈송검.관측지표:술전영양상태급영양풍험평고,포괄체중、체중지수、영양풍험사사등;안전성지표,포괄혈상규、혈전해질、곡초전안매(AST)、곡병전안매(ALT)、총담홍소、결합담홍소、뇨소담(BUN)、기항、혈당등;유효성지표,포괄혈홍단백、백단백、총단백등.결과 량조술후제8천적백단백급총단백치균재정상범위내,단연구조적측량치교대조조고(P=0.000),차연구조술후제8천여제1천적총단백차치교대조조고(P=0.002).술후제8천대조조적AST급BUN치승고,이연구조적AST급BUN균재정상범위차명현저우대조조(P=0.025,P=0.013).량조간재생명체정변화、불량사건발생솔、혈상규、혈전해질、혈당、혈지등방면차이무통계학의의(P균>0.05).결론 함감람유지방유제재식관암술후장외영양지지중적응용시안전유효적;상대우중/장련지방유제이언,기대AST급BUN적영향교소.
Objective To assess the safety and efficacy of an olive oil-based lipid emulsion for parenteral nutrition in patients after esophagectomy.Methods In the randomized controlled trial,60 patients undergoing esophagectomy were divided into study group(n=30,received olive oil-based lipid emulsion)and control group [n=30,received medium-chain triglyceride/long-chain triglyceride(MCT/LCT)emulsion].The parenteral nutrition Was provided for 7-10 postoperative days.The nutritional formulas were equivalent in nitrogen,calorie,osmotic pressure,and fluid volume.Peripheral venous blood tests were performed before operation and on the first and eighth postoperative days.All the patients were evaluated by nutritional status(weight,body mass index,nutritional risk screening,etc.),safety profiles[full blood test,electrolytes,aspartate aminotransferase(AST),alanine amiotransferase(ALT),total bilirubin and direct bilirubin,blood urea nitrogen(BUN),creatinine,blood glucose,etc.],and efficacy indicators(hemoglobin,albumin,total protein,etc.).Results The albumin and total protein levels returned to the normal ranges in beth groups 8 days after operation,although both levels were significantly higher in study group(P=0.000).Also,the difference of total protein levels between the eighth and first postoperative days Was significantly higher in the study group(P=0.002).In addition,the AST and BUN readings returned to normal ranges 8 days after operation in the study group, which were significantly lower than those in control group (P = 0.025, P = 0.013).No serious adverse events were reported in both groups.Other nutritional parameters, renal and hepatic safety profiels, vital signs, and hematology showed no significant difference between two groups.Conclusions Olive oil-based lipid emulsion is a safe and efficient lipid emulsion for parenteral nutrition in patients undergoing esophagectomy.Compared with MCT/LCT, it has less effect on AST and BUN.