重症急性胰腺炎的肠外营养支持治疗

THE EFFECT OF TOTAL PARENTERAL NUTRITION ON SEVERE ACUTE PANCREATITIS

报导１９９１年１２ 月～１９９７ 年１２月４２例重症急性胰炎病人的ＴＰＮ支持治疗，其中男性１８ 例，女性２４例，手术２８例，非手术１４例，死亡６ 例，鉴于ＳＡＰ病人胰岛素的拮抗作用，在ＴＰＮ支持中增加脂肪乳剂供能（糖脂比例１～２：１）。根据测得血中ＴＧ水平给以不同浓度的Ｉｎｔｒｌｉｐｉｄ，控制磷脂摄入量。用后监测血ＴＧ增高不明显。本组治愈率为８５．５％ （３６／４２）。我们认为适量脂肪乳剂供能，增加支链氨基酸的用量，适当延长ＴＰＮ支持时间，对纠正负氮平衡，促进疾病的康复起到事半功倍的作用。

Fourty-two patients with severe acute pancrentitis (SAP) were treated from from 1991 to 1996.of them eighteen are males,twenty-four females.28 cases were treated by operation,the others treated by non-operative method.All patients used total parenteral nutrition(TPN) as nutritional support.Because patients with SAP can not utilize glucose effectively,the amount of lipid was increased to provide enough energy.(Glucose:lipid is 1-2:1).The serumal level of triglyceride(TG) had no significient rise after intravenous use of lipid.We used compound amino acid solution to provide nitrogen.The overall survive rate was 85.5%(36/42).We conclude that TPN is safe and beneficial to patients with SAP.