创伤后腹腔感染患者营养素及有关因素的变化

Changes of nutritive and related elements in patients with intraperitoneal sepsis following operative trauma

本文通过对13例腹部手术创伤后肠外瘘并有腹腔感染需营养支持患者的营养素及有关因素进行10天系统观察,发现在常用的 TPN(热量=146.6kJ·ks^(-1)/d,非蛋白热量:氮=500kJ:1g)支持下,机体代谢有下列特点:1.在观察期内,机体血浆中不同半衰期的蛋白质均低于正常值.2.血浆中脯氨酸,芳香族氨基酸始终较高,精氨酸明显下降.而支链氨基酸稍有升高.3.血中脂类、糖、尿素氮、大部分酶类和电解质及微量元素均在正常范围.4.除维生素 B_2有非常显著地持续下降外,其余维生素正常。5.分解激素始终高于正常水平,但生长激素在第10天下降,胰岛素无明显变化.以上这些发现,均有助于研究创伤并有感染患者的营养支持.

In this study,the nutritive and related elements of 13 in- traperitoneal sepsis after operation,whom were supported by TPN,were observ- ed for 10 days.The results showed that under routine TPN regime (ener- gy=146.6 kJ·kg^(-1)/d,nonprotein energy:nitrogen=500 kJ:1g)the body metabolism had following characters:(1)The levels of different half-live plasma protein were constantly lower than normal range during observing period.(2)The serum levels of amino acids shown that the proline and aromatic amino acids were higher and arginine was lower than normal range, while the value of branchain amino acids minorly increased only.(3)No sig- nificant changes were found in levels of blood lipids, glucose,urea nitrogen, some enzymes,electrolytes and minerals.(4)The levels of serum vitamins were not changed except vitamin B_2 which was decreased progressively.(5) The increase of serum levels of catabolic hormons was seen,but the growth hormone decreased at the 10th day of the investigation All of these findings are benifit for studing nutritional support of septic patients.