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经皮经肝胆道引流联合胆汁回输及经鼻空肠管肠内营养对内脏蛋白及肝功能的影响

[Effect of percutaneous transhepatic cholangial drainage with bile reinfusion and enteral nutrition via the nasojejunal tube on visceral protein and hepatic function].

作者信息

Wang Wei-dong, Chen Xiao-wu, He Wei, Liu Qing-bo, Wu Zhi-qiang

机构信息

Department of General Surgery, First People's Hospital of Shunde District, Foshan 528300, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2010 Jan;30(1):146-8.

Abstract

OBJECTIVE

To discuss the clinical value of percutaneous transhepatic cholangial drainage (PTCD) combined with nasojejunal tube for bile reinfusion and enteral nutrition for patients with malignant obstructive jaundice.

METHODS

Forty patients with malignant obstructive jaundice were randomly divided into bile reinfusion group (n=20) and exclusive external drainage group (control group, n=20), and the clinical data concerning the hepatic function, visceral protein and postoperative complications of the patients were collected.

RESULTS

In both of the two groups, the levels of ALT, AST, and TB-2 reduced significantly after the operation as compared with the preperative levels (P<0.05), and no significant difference was found in the postoperative hepatic function between the two groups (P>0.05). The postoperative levels of the visceral proteins such as ALB, TRF and PRE increased significantly after the operation (P<0.05), and the changes in ALB and PRE were comparable between the two groups (P>0.05). TRF was significantly higher in bile reinfusion group than in the control group.

CONCLUSION

PTCD combined with bile reinfusion and early enteral nutrition via the nasojejunal tube may facilitate the recovery of hepatic function and visceral proteins in patients with malignant obstructive jaundice.

摘要

目的

探讨经皮经肝胆道引流术(PTCD)联合鼻空肠管胆汁回输及肠内营养对恶性梗阻性黄疸患者的临床价值。

方法

将40例恶性梗阻性黄疸患者随机分为胆汁回输组(n = 20)和单纯外引流组(对照组,n = 20),收集患者肝功能、内脏蛋白及术后并发症等临床资料。

结果

两组患者术后ALT、AST、TB-2水平均较术前显著降低(P < 0.05),两组术后肝功能比较差异无统计学意义(P > 0.05)。术后两组患者ALB、TRF、PRE等内脏蛋白水平均显著升高(P < 0.05),ALB和PRE的变化两组间比较差异无统计学意义(P > 0.05),胆汁回输组TRF水平显著高于对照组。

结论

PTCD联合胆汁回输及经鼻空肠管早期肠内营养可促进恶性梗阻性黄疸患者肝功能及内脏蛋白的恢复。

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