中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
Chinese Journal of Clinical Nutrition
2015年
5期
287-291
,共5页
胰十二指肠切除术%结构脂肪乳%肠外营养
胰十二指腸切除術%結構脂肪乳%腸外營養
이십이지장절제술%결구지방유%장외영양
Pancreaticoduodenectomy%Structured triglyceride%Parenteral nutrition
目的 探讨恶性梗阻性黄疸(MOJ)患者胰十二指肠切除术后使用结构脂肪乳的临床经验.方法 回顾性分析21例本院行胰十二指肠切除手术的MOJ患者,术后第1天开始接受肠外营养(PN),根据PN使用脂肪乳的不同分为结构脂肪乳组(7例)和中/长链脂肪乳组(MCT/LCT组,14例),观察两组患者肝功能、血脂、白蛋白(ALB)及术后并发症等.结果 结构脂肪乳组的三酰甘油水平在术后第3和7天均显著低于MCT/LCT组[第3天:(1.85 ±0.90) mmol/L比(2.18±1.41) mmol/L;第7天:(1.62±0.78) mmol/L比(2.46±1.62) mmol/L;P均=0.042],高密度脂蛋白水平在术后第7天显著高于MCT/LCT组[(0.67±0.64) mmol/L比(0.45 ±0.15) mmol/L,P=0.046],ALB在术后第3天恢复正常,明显优于MCT/LCT组[(35.50±2.91) g/L比(30.66±5.08) g/L,P=0.048],两组术后肝功能、住院时间、切口愈合情况、全身炎症反应综合征和感染发生差异均无统计学意义(P均＞0.05).结论 恶性梗阻性黄疸患者胰十二指肠切除术后使用结构脂肪乳作为PN的重要组成部分,其对脂类代谢干扰较MCT/LCT更少,且能快速提高ALB水平,耐受性和安全性良好.
目的 探討噁性梗阻性黃疸(MOJ)患者胰十二指腸切除術後使用結構脂肪乳的臨床經驗.方法 迴顧性分析21例本院行胰十二指腸切除手術的MOJ患者,術後第1天開始接受腸外營養(PN),根據PN使用脂肪乳的不同分為結構脂肪乳組(7例)和中/長鏈脂肪乳組(MCT/LCT組,14例),觀察兩組患者肝功能、血脂、白蛋白(ALB)及術後併髮癥等.結果 結構脂肪乳組的三酰甘油水平在術後第3和7天均顯著低于MCT/LCT組[第3天:(1.85 ±0.90) mmol/L比(2.18±1.41) mmol/L;第7天:(1.62±0.78) mmol/L比(2.46±1.62) mmol/L;P均=0.042],高密度脂蛋白水平在術後第7天顯著高于MCT/LCT組[(0.67±0.64) mmol/L比(0.45 ±0.15) mmol/L,P=0.046],ALB在術後第3天恢複正常,明顯優于MCT/LCT組[(35.50±2.91) g/L比(30.66±5.08) g/L,P=0.048],兩組術後肝功能、住院時間、切口愈閤情況、全身炎癥反應綜閤徵和感染髮生差異均無統計學意義(P均＞0.05).結論 噁性梗阻性黃疸患者胰十二指腸切除術後使用結構脂肪乳作為PN的重要組成部分,其對脂類代謝榦擾較MCT/LCT更少,且能快速提高ALB水平,耐受性和安全性良好.
목적 탐토악성경조성황달(MOJ)환자이십이지장절제술후사용결구지방유적림상경험.방법 회고성분석21례본원행이십이지장절제수술적MOJ환자,술후제1천개시접수장외영양(PN),근거PN사용지방유적불동분위결구지방유조(7례)화중/장련지방유조(MCT/LCT조,14례),관찰량조환자간공능、혈지、백단백(ALB)급술후병발증등.결과 결구지방유조적삼선감유수평재술후제3화7천균현저저우MCT/LCT조[제3천:(1.85 ±0.90) mmol/L비(2.18±1.41) mmol/L;제7천:(1.62±0.78) mmol/L비(2.46±1.62) mmol/L;P균=0.042],고밀도지단백수평재술후제7천현저고우MCT/LCT조[(0.67±0.64) mmol/L비(0.45 ±0.15) mmol/L,P=0.046],ALB재술후제3천회복정상,명현우우MCT/LCT조[(35.50±2.91) g/L비(30.66±5.08) g/L,P=0.048],량조술후간공능、주원시간、절구유합정황、전신염증반응종합정화감염발생차이균무통계학의의(P균＞0.05).결론 악성경조성황달환자이십이지장절제술후사용결구지방유작위PN적중요조성부분,기대지류대사간우교MCT/LCT경소,차능쾌속제고ALB수평,내수성화안전성량호.
Objective To investigate the application of structured triglyceride (STG) in malignant obstructive jaundice (MOJ) patients after pancreaticoduodenectomy.Methods The records of 21 MOJ patients received pancreaticoduodenectomy in our hospital were retrospectively analyzed.The patients received parenteral nutrition on the first postoperative day, of whom 7 were given STG (STG group) and 14 were given medium and long chain triglyceride (MCT/LCT group).The changes of liver function, lipid profile, albumin, and postoperative complications were compared between the two groups.Results The triglyceride levels in the STG group on the 3rd and 7th postoperative days were significantly lower than those in the MCT/LCT group [3rd day:(1.85 ±0.90) mmol/L vs.(2.18 ±1.41) mmol/L;7th day: (1.62 ±0.78) mmol/L vs.(2.46± 1.62) mmol/L;both P =0.042];the level of high-density lipoprotein on the 7th postoperative day was significantly higher than that in the MCT/LCT group [(0.67 ±0.64) mmol/L vs.(0.45 ±0.15) mmol/L, P =0.046].The albumin in the STG group returned to normal on the 3rd postoperative day, which was significantly higher than that in the MCT/LCT group [(35.50 ±2.91) g/L vs.(30.66 ±5.08) g/L, P =0.048].There were no significant differences in terms of liver function, length of hospital stay, wound healing, systemic inflammatory response syndrome, and infection between the two groups.Conclusions Parenteral nutrition with structured triglyceride after pancreaticoduodenectomy in MOJ patients is tolerable and safe.STG has less influence on lipid metabolism than MCT/LCT does, and can increase albumin level rapidly.
