肠外营养对胃肠动力及分泌的影响

Effects of parenteral nutrients on gastrointestinal motility and secretion

肠外营养支持广泛应用于临床 ,然而肠外途径营养及循环中各营养素对胃肠道动力及胃肠分泌的影响却知之甚少。本文综述肠外营养支持及葡萄糖、氨基酸、脂肪乳剂对胃肠动力及分泌的影响。静脉输注葡萄糖可抑制胃肠动力和分泌 ,这种抑制效应具有剂量依赖性。静脉输注高剂量氨基酸 ,则能刺激胃酸分泌、胰液分泌、胆囊收缩和肠道动力。静脉输注脂肪乳剂 ,可延缓胃排空并干扰消化期肠道动力模式。接受肠外营养支持病人胆囊活力降低 ,胆汁淤积 。

Parenteral nutritional support are used widely in clinical practice.Little is knownabout the effects of macronutrients on gastrointestinal motility and secretion.Several studies have provided evidence that nutrients during the circulatory phase of digestion influence gastrointestinal motility and secretion.Glucose exerts an inhibitory effect on gastrointestinal motility and secretion.The inhibitory effect of glucose is dose dependent.Circulating amino acids at high concentrations stimulate gastric acid secretion,pancreatic enzyme secretion,gallbladder contraction and intestinal motility.Intravenous infusion of fat emulsions delays gastric emptying and interrupts the interdigestive intestinal motor pattern.