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[食管静脉曲张患者术后应用脂肪乳剂的全胃肠外营养]

[Postoperative total parenteral nutrition with fat emulsion for patients with esophageal varices].

作者信息

Takai T, Nagayama M, Okuno M, Ikehara T, Sakamoto K, Lee J T, Umeyama K

机构信息

First Department of Surgery, Osaka City University Medical School, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Mar;89(3):325-35.

PMID:3134607
Abstract

The administration of fat emulsion and total parenteral nutrition (TPN) was evaluated in 68 patients with liver disorders who underwent surgical treatment for esophageal varices. The subjects were divided into two groups, fat group (28 cases) and non-fat group (40 cases) according to with or without the administration of fat emulsion during the period of postoperative TPN. The results of liver function tests, blood glucose levels, intravenous fat tolerance tests, serum lipid levels, fatty acid composition in serum total lipids, nitrogen balances and body weight changes during the period of postoperative TPN were compared between both groups. Conclusions as follows; 1. The administration of fat emulsion during the period of postoperative TPN did not worsen the results of liver function tests, and relatively low levels of blood glucose were retained. 2. The removal rates of fat emulsion from the blood (K2 values) during the period of postoperative TPN were significantly higher than in those preoperative period, and changes in serum lipid level revealed no tendency toward retention of fat emulsion administered intravenously. 3. Cumulative nitrogen balance were almost similar in both groups. 4. The administration of fat emulsion the period of during postoperative TPN corrected the abnormalities of fatty acid composition in serum total lipid. Further, it was suggested that approximately more than 5 ml/kg/day of 10% fat emulsion would be advisable to prevent the decrease of linoleic acid. 5. These results suggested that the administration of fat emulsion was useful for the patients with esophageal varices during the period of postoperative TPN.

摘要

对68例因食管静脉曲张接受手术治疗的肝病患者进行了脂肪乳剂和全胃肠外营养(TPN)的应用评估。根据术后TPN期间是否给予脂肪乳剂,将受试者分为两组,脂肪组(28例)和非脂肪组(40例)。比较了两组术后TPN期间的肝功能检查结果、血糖水平、静脉脂肪耐量试验、血脂水平、血清总脂质中的脂肪酸组成、氮平衡和体重变化。结论如下:1.术后TPN期间给予脂肪乳剂并未使肝功能检查结果恶化,且血糖水平维持在相对较低水平。2.术后TPN期间脂肪乳剂从血液中的清除率(K2值)显著高于术前,血脂水平变化未显示出静脉给予脂肪乳剂有潴留倾向。3.两组的累积氮平衡几乎相似。4.术后TPN期间给予脂肪乳剂可纠正血清总脂质中脂肪酸组成的异常。此外,建议给予约5ml/kg/天以上的10%脂肪乳剂以防止亚油酸减少。5.这些结果表明,术后TPN期间给予脂肪乳剂对食管静脉曲张患者有益。

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