肝移植术后早期脂肪乳剂支持治疗对移植肝功能影响的临床研究

Influence of total parenteral nutrition containing fat emulsion on hepatic function in patients with liver transplantation

目的 研究含脂肪乳剂的肠外营养 (TPN)对肝移植受体肝脏功能的影响。方法 选择2 0 0 1年 9月～ 2 0 0 4年 6月期间在我所肝移植中心住院行肝移植手术治疗的患者 ,取符合标准的 30例作为研究对象 ,随机分组 ,进行前瞻性的临床研究。肝移植术后 6h开始给予单糖或脂肪乳剂和单糖联合功能的TPN(分别为Glu对照组和MCT/LCT组 ) ,TPN期为 7d ,期间严格禁食。于TPN后第 1、4、7、10、30、90及 180天收集标本 ,检测血ALT、AST、GGT、TBil及DBil。结果 TPN支持后MCT/LCT和Glu组ALT、AST、GGT、TBil及DBil水平均呈现下降趋势 ,与单糖组相比 ,脂肪乳组降低迅速。

Objective To study the influence of TPN containing glucose or glucose plus fat emulsion on hepatic function in patients with live r transplantation. Methods Thirty patients with liver transplantation from September 2001 to June 2004 were selected to undergo TPN. Patients were randomly assigned to two groups containing 15 each according to the different energy sources. Patients in MCT/LCT group were given MCT/LCT and glucose. Glucose was the only energy source in Glu Group. The specimen of blood was obtained on day 1, 4, 7, 10, 30, 90 and 180 after TPN. Serum ALT, AST, GGT, TBil and DBil were determined. Results ALT, AST, GGT, TBil and DBil in MCT/LCT and Glu group were all decreased after TPN was administered. Compared with Glu group, serum ALT, AST, GGT, TBil and DBil levels in Group MCT/LCT were decreased dramatically. Conclusions TPN containing fat emulsion is safe and effective in patients with liver transplantation, while TPN with kilocalorie supplemented by Glu only is not beneficial for improving liver function in the early stage after liver transplantation.