结构甘油三酯在肝癌肝切除术后肠外营养中的应用

STRUCTURED TRIGLYCERIDES WERE WELL TOLERATED AND INDUCED AFTER HEPATECTOMY IN PATIENTS WITH HEPATOCARCINOMA

目的评价肝癌肝切除术后使用结构甘油三酯进行肠外营养支持的临床研究。方法符合入选标准的肝癌肝部分切除患者49例,进入研究组和对照组。研究组(n=25)术后第一天开始肠外营养(PN),按照欧洲肠内肠外营养学会(ESPEN)推荐标准,采用结构甘油三酯(STG)配制"全合一"3L袋营养液,同时补足葡萄糖、维生素、微量元素,肠外营养5～7天。对照组(n=24)术后仅接受5%葡萄糖、相同量的氨基酸及相同的微量元素、电解质、复合维生素,液体总量与研究组相同。观察两组肝功能、肾功能、血脂、血糖、静脉炎、全身炎症反应综合征(SIRS)等情况。结果与对照组相比,肝部分切除术后,标准剂量结构甘油三酯对患者术后肝功能恢复有利,能够减少术后并发症,减轻对肝功能的损伤,减轻血浆蛋白质的损失,降低机体炎症反应。结论肝切除术后使用STG进行肠外营养支持是安全和有效的,ESPEN标准同样适用于中国患者。

Objectives To observe the role of structured triglycerides in nutrition support after liver resection in patients with liver cancer.Methods 49 cases after heptectomy surgical procedure were randomly assigned into 2 groups： STG group（n=25）,receiving peripheral parenteral nutrition support with 1.3×REE and nitrogen 0.20（0.19~0.21）g/kg/d in regular ＂3 liter bag＂,and contral group receiving regular fluid supplement,with same nitrogen.Check postoperative liver function,plasma proteins and body composition.Results Liver functions was found to be improved,postoperative complications was progressed,and inflammation was corrected.Conclusion The structured triglycerides was well tolerated and induced,and nutrition therapy with STG is an effective method for postoperative support in patients after hepotectomy with liver cancer.