部分肠内营养支持对肝硬化病人的治疗效果

INFLUENCE OF PARTIAL ENTERAL NUTRITION ON PATIENTS WITH CIRRHOSIS

目的探讨部分肠内营养（PEN）对肝硬化病人的治疗效果。方法43例肝硬化病人按病人意愿分为PEN组与部分肠外营养（PPN）组，两组分别给予PEN及PPN支持治疗10d，于治疗前和营养支持后第7、10天分别测定血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TB）及转铁蛋白（TRF）、前清蛋白（PAB）和清蛋白（Alb）各项指标的变化。结果治疗第10天两组ALT、AST与TB均明显低于治疗前（F=5．67～11．32，q=3．35～3．96，P〈0．05），并且PEN组下降幅度明显大于PPN组（t=2．30～4．32，P〈0．05）。进行营养支持7d后，两组TRF和PAB较营养前明显升高（F=10．80～30．24，q=3．90～11.53，P〈0．05），两组比较无明显差异。第10天时，PAB、TRF与Alb等3种指标均明显高于治疗前（F=30．30～112．24，q=13．90～22．53，P〈0．05），且PEN组明显高于PPN组（t=2．65～5．61，P〈0．05）。结论PEN与PPN都能促进肝硬化病人肝功能与能量代谢的恢复，但PEN的效果更明显，优势更大。

Objective To evaluate the therapeutic effect of partial enteral nutrition （PEN） on patients with liver cirrhosis. Methods According to their wish, 43 cirrhotic patients were divided into PEN （23 cases） and partial parenteral nutrition （PPN, 20cases） groups and given PEN or PPN, separately, for 10 days. The ALT, AST, TB, TRF, PAB and Alb were determined before and on the 7th and 10th day after treatment. Results On day 10 of the treatment, the levels of ALT, AST and TB in both groups were significantly lower than those before treatment （F=5.67-11.32;q=3.35 3.96;P〈0.05）, but it was more lower in PEN group （t=2.30 4.32,P〈0.05）. After seven days of treatment, the TRF and PAB were increased compared with before treatment （F=10.80 30.24;q=3.90-11.53;P〈0.05）, the diffrences between the two groups were not significant; on day 10, the levels of PAB, TRF and Alb were higher than the levels of before treatment （F=30.30 112.24;q=13.90-22.53; P〈0.05）, the levels being higher in PEN group （t=3.85 5.61,P〈0.05）. Conclusion Both PEN and PPN can improve the liver function and energy metabolism in patients with liver cirrhosis, but the effect of PEN is much better.