低热量肠外营养加生长激素在腹部外科手术患者中的应用

Hypocaloric parenteral nutrition support and rhGH for the abdominal surgical operation patients

目的评估腹部外科手术患者应用低热量肠外营养(PN)加重组生长激素(rhGH)的治疗效果.方法随机入组48例,低热量PN+rhGH组16例,低热量PN作为对照组32例.提供总热量62.8～83.7 kJ(15～20 kcal)/(kg.d),氮量0.10～0.12 g/(kg.d).rhGH 8 U/d,皮下注射7 d.结果治疗7 d后,与治疗前相比,低热量PN+rhGH组总淋巴细胞计数、血浆蛋白水平显著升高,氮平衡得到明显改善,除总淋巴细胞计数外都明显高于对照组.治疗过程中两组患者均未出现明显的糖、脂代谢异常和肝酶谱变化的代谢性并发症.结论低热量PN+rhGH支持治疗能显著提高营养治疗的临床效果,有效改善腹部外科手术患者的预后.

Objective To evaluate the clinical effects of hypoc,aloric parenteral nutrition （HPN） and recombinant human growth hormone （rhGH） on abdominal surgical operation patients. Methods Forty - eight patients were randomized to two groups, both groups received HPN providing 62.8 - 83.7 kJ （ 15 - 20 kcal）/（ kg·d） and 0.10 - 0.12 gN/ （ kg·d）. In addition, HPN ＋ rhGH group （ n = 16） received subcutaneous injections of rhGH at a dose of 8 IU daily for 7 days, Results After treatment for 7 days, total lymphocyte count and serum proteins were significantly increased, and nitrogen balance improved remarkably in HPN ＋ rhGH group as compared with those before treatment. Except for the total lymphocyte account, other indexes were improved significantly as compared with control group. During the course of the treatment, no complications of abnormal glucose and fat metabolism and liver function occurred. Conclusion HPN ＋ rhGH support could significantly improve the clinical outcome and the prognosis of the patients subject to abdominal surgical operation.