Zoli G, Ballinger A, Healy J, O'Donnell L J, Clark M, Farthing M J
Department of Gastroenterology, St Bartholomew's Hospital, London, UK.
Lancet. 1993 May 15;341(8855):1240-1. doi: 10.1016/0140-6736(93)91146-d.
Patients receiving total intravenous nutrition have inert gallbladders; gallbladder sludge and gallstones often develop, but are preventable if gallbladder emptying can be improved. We measured the effect of giving rapid intravenous infusions of aminoacid solutions in eight normal subjects. Four regimens were tested (250 mL over 30 min, 250 mL over 10 min, 125 mL over 5 min, and 50 mL over 5 min). Gallbladder emptying, as measured by ultrasound and cholecystokinin release, depended on both the amount and the rate of aminoacid infusion. Rapid infusion of 125 mL of an aminoacid mixture (Synthamin 14 without electrolytes) over 5 min (2.1 g per min) produced a 64% reduction in gallbladder volume within 30 min, whereas a 50 mL infusion over 5 min produced only a 22% reduction. Intermittent rapid infusion of small amounts of aminoacids may prevent gallstones in patients receiving intravenous nutrition.
接受全胃肠外营养的患者胆囊呈惰性；常形成胆囊泥沙样沉积物和胆结石，但如果能改善胆囊排空，这些情况是可以预防的。我们测定了在8名正常受试者中快速静脉输注氨基酸溶液的效果。测试了四种方案（30分钟内输注250毫升、10分钟内输注250毫升、5分钟内输注125毫升、5分钟内输注50毫升）。通过超声和胆囊收缩素释放测定的胆囊排空，取决于氨基酸输注的量和速度。5分钟内快速输注125毫升氨基酸混合物（不含电解质的14种合成氨基酸）（每分钟2.1克），30分钟内胆囊体积减少64%，而5分钟内输注50毫升仅使胆囊体积减少22%。间歇性快速输注少量氨基酸可能预防接受静脉营养患者的胆结石形成。
