CAJ | 학술논문

目的研究静脉营养及生长激素联合应用在外科危重病人的临床效果.方法1998年1月～1999年12月,对16例外科危重病人应用静脉营养联合生长激素治疗.其中,多器官功能衰竭4例,胰腺癌术后3例,结肠癌术后4例,卵巢癌伴肠粘连1例,脑出血2例,急性坏死性胰腺炎1例,淋巴瘤术后1例.男:女＝11:3,平均年龄65.86±12.4岁,生长激素4.5～8U/d,生长激素应用时间:8.07±4.5d.结果(1)16例患者中痊愈出院9例,7例因严重感染,多器官功能衰竭,呼吸衰竭死亡.(2)在14例肾功能正常组(血肌酐<115μmol/L),治疗前血浆BUN9.439±2.068μmol/L,治疗后BUN7.056±1.882μmol/L,二者差异有非常显著性(P<0.01).(3)2例肾功能不正常的病例,治疗前BUN分别为19.19及28.02μmol/L,治疗后为28.81及33.74μmol/L.(4)血浆总蛋白及白蛋白水平治疗前后差异无显著性(治疗前31.8±5.1g/L,治疗后32.47±6.43g/L,P>0.05).结论在肾功能正常的情况下,术后危重患者应用生长激素可以降低血浆尿素氮水平,其临床意义及机理有待于进一步研究探讨.
목적연구정맥영양급생장격소연합응용재외과위중병인적림상효과.방법1998년1월～1999년12월,대16예외과위중병인응용정맥영양연합생장격소치료.기중,다기관공능쇠갈4례,이선암술후3례,결장암술후4례,란소암반장점련1례,뇌출혈2례,급성배사성이선염1례,림파류술후1례.남:녀＝11:3,평균년령65.86±12.4세,생장격소4.5～8U/d,생장격소응용시간:8.07±4.5d.결과(1)16례환자중전유출원9례,7례인엄중감염,다기관공능쇠갈,호흡쇠갈사망.(2)재14례신공능정상조(혈기항<115μmol/L),치료전혈장BUN9.439±2.068μmol/L,치료후BUN7.056±1.882μmol/L,이자차이유비상현저성(P<0.01).(3)2례신공능불정상적병례,치료전BUN분별위19.19급28.02μmol/L,치료후위28.81급33.74μmol/L.(4)혈장총단백급백단백수평치료전후차이무현저성(치료전31.8±5.1g/L,치료후32.47±6.43g/L,P>0.05).결론재신공능정상적정황하,술후위중환자응용생장격소가이강저혈장뇨소담수평,기림상의의급궤리유대우진일보연구탐토.
Objective To study the effect of combinant applications of PN and GH in the therapy of critical care patients. Methods We treated 16 cases of critical care patients with the combination of PN and. GH, of which there were MOF in 4, acute pancreatitis in 1, the others are postoperative patients, including panereatic cancer in 3, colon cancer in 4, ovaries cancer in 2, lymphoma in 1. Male: Female = 11: 3, the average age is 65.85 ± 12.4, the usage of the GH is 4.5～8u/day. Results (1)9 cases were cured and the other 7 cases died from severe irdection, MOF and respiratory failure. (2)in the cases whose renal function is normal, the BUN level significantly declined after the therapy. (BUN = 9. 4393 ± 2. 068mmol/l before the therapy versus BUN = 7. 0564 ± 1. 882mmol/l after the therapy, P < 0.01 ) (3)in the 2 cases whose renal function were abnormal(Cr > 115umol/l ), the BUN level before the therapy were 19.19 mmol/l and 28.02mmol/l, and 28.81mmol/l and 33.74mmol/L after the therapy. (4) The TP and ALB level after the therapy were not significantly diferent from before. (31.8 ± 5.08g/l before the therapy versus 32.47 ± 6.43g/l aftet the therapy. P > 0.05). Conclusions In case of normal renal function, the combinant application of PN and GH in the therapy of critical care patients could reduce the BUN level in plasma. The clinical significance and its mechanism are to be further studied.