中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2008年
10期
724-727
,共4页
罗时敏%曹杰%罗建威%谭明华
囉時敏%曹傑%囉建威%譚明華
라시민%조걸%라건위%담명화
肝硬化%肝切除术%肠外营养%肠内营养
肝硬化%肝切除術%腸外營養%腸內營養
간경화%간절제술%장외영양%장내영양
Liver cirrhosis%Hepatectomy%Parenteral nutrition%Enteral nutrition
目的 探讨肝硬化大鼠肝切除术后不同营养支持途径的作用.方法 6只正常大鼠作为正常对照组,30只肝硬化大鼠随机分为术前组6只,肝切除+颈内静脉插管术后1d组6只,肝切除+颈内静脉插管术后行PN 5 d组6只,肝切除+胃造瘘术后1 d组6只,肝切除+胃造瘘术后行EN 5 d组6只.测大鼠肝功能、免疫功能、炎症反应和脂质过氧化指标.结果 与PN 5 d组比较,EN 5 d组血清AST、ALT、ALP显著下降(P<0.05),血清ALB、IGF-1显著升高(P<0.05),外周血CD3+、CD4+、CD4+/CD8+显著升高(P<0.05),血清IL-6、IFN-γ、TNF-α、MDA显著下降(P<0.05),血清SOD活性显著升高(P<0.05).结论 EN可以加快肝硬化大鼠肝切除术后肝功能的恢复,避免胆汁淤积,促进肝脏蛋白合成,改善术后免疫功能低下,减轻炎症反应和脂质过氧化损伤.
目的 探討肝硬化大鼠肝切除術後不同營養支持途徑的作用.方法 6隻正常大鼠作為正常對照組,30隻肝硬化大鼠隨機分為術前組6隻,肝切除+頸內靜脈插管術後1d組6隻,肝切除+頸內靜脈插管術後行PN 5 d組6隻,肝切除+胃造瘺術後1 d組6隻,肝切除+胃造瘺術後行EN 5 d組6隻.測大鼠肝功能、免疫功能、炎癥反應和脂質過氧化指標.結果 與PN 5 d組比較,EN 5 d組血清AST、ALT、ALP顯著下降(P<0.05),血清ALB、IGF-1顯著升高(P<0.05),外週血CD3+、CD4+、CD4+/CD8+顯著升高(P<0.05),血清IL-6、IFN-γ、TNF-α、MDA顯著下降(P<0.05),血清SOD活性顯著升高(P<0.05).結論 EN可以加快肝硬化大鼠肝切除術後肝功能的恢複,避免膽汁淤積,促進肝髒蛋白閤成,改善術後免疫功能低下,減輕炎癥反應和脂質過氧化損傷.
목적 탐토간경화대서간절제술후불동영양지지도경적작용.방법 6지정상대서작위정상대조조,30지간경화대서수궤분위술전조6지,간절제+경내정맥삽관술후1d조6지,간절제+경내정맥삽관술후행PN 5 d조6지,간절제+위조루술후1 d조6지,간절제+위조루술후행EN 5 d조6지.측대서간공능、면역공능、염증반응화지질과양화지표.결과 여PN 5 d조비교,EN 5 d조혈청AST、ALT、ALP현저하강(P<0.05),혈청ALB、IGF-1현저승고(P<0.05),외주혈CD3+、CD4+、CD4+/CD8+현저승고(P<0.05),혈청IL-6、IFN-γ、TNF-α、MDA현저하강(P<0.05),혈청SOD활성현저승고(P<0.05).결론 EN가이가쾌간경화대서간절제술후간공능적회복,피면담즙어적,촉진간장단백합성,개선술후면역공능저하,감경염증반응화지질과양화손상.
Objective To explore the role of posthepatectomy different support routes in cir-rhotic rats. Methods A total of 6 normal rats severed as normal group, 30 rats with liver cirrhosis were randomly divided into pre-operation group (n=6), posthepatectomy with jugular vein catheter 1 day group (n=6), post-operation PN 5 day group (n=6), posthepatectomy with gastrostomy 1 day group (n=6), post-operation EN 5 day group (n=6). Liver function, immunological function, in-flammatory responses, and lipid peroxidation were determined. Results Compared with the PN 5 day group, serum AST, ALT and ALP were lower(P<0.05), serum ALB and IGF-1 were higher(P<0.05), the peripheral blood CD3+ , CD4+ and CD4+/CD8+ ratio were higher(Pz<0.05), serum IL-6,IFN-γ, TNF-α and MDA content were lower(P<0.05), serum SOD activity was higher(P<0.05) in the EN 5 day group. Conclusion Posthepatectomy enteral nutrition in cirrhotic rats can speed up liver function recovery, prevent cholestasis, promote liver protein synthesis, ameliorate the damage of im-munological function and reduce inflammatory responses and lipid peroxidation damage.