联合应用rhGH、Gln对全小肠切除术后营养素吸收的影响  

Effects of rhGH and Glutamine on nutrients absorptive adaptation in patient after total small bowel resection

作　　者：刘坚[1] 王彬[2] 周连妹[2] 

机构地区：[1]杭州市第一人民医院外科,310006 [2]浙江大学医学院附属第二医院外科

出　　处：《中国临床营养杂志》2000年第4期220-224,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的　探讨联合应用生长激素 (rhGH)、谷氨酰胺 (Gln)对全小肠切除术后患者残余胃肠道代偿吸收的作用。　方法　以一例全小肠切除术后的患儿自身对照 ,采用D 木糖吸收试验、15N 甘氨酸示踪试验及13 C 棕榈酸呼气试验测定患儿在术后第 15个月及第 2 4个月两次联合应用rhGH0 .12～ 0 .14mg·kg 1·d· 1× 2～ 3w ,与Gln 0 .2 8g·kg 1·d· 1× 2～ 3w后 ,残留肠吸收功能的变化。在术后第 15个月用全消化道钡餐造影观察胃肠形态及消化道通过时间。　结果　患儿对氨基酸、脂肪酸的代偿吸收能力较好 ,并且在用rhGH +Gln治疗后还能进一步提高 ,而对单糖的代偿吸收较差 ,在治疗后也无明显改善。胃肠造影发现结肠的形态代偿最为明显 ,钡剂在消化道通过时间为 2 2h。　结论　用这一治疗方法能够在短期内促进全小肠切除术后患者残留肠道的代偿吸收功能 ,本研究还发现营养素的代偿吸收可能在结肠中进行。Objdctive To investigate the effects of rhGH and Gln on absorptive adaptation in patient after total small bowel resection Mothods A 7 year old boy patient who had undergone total small bowel and ascending & transverse colon resection was involved in this study,we treated this patient with rhGH(0.12～ 0.14 mg·kg 1 ·d 1 ×2～3w)and together with Gln (0.28g·kg 1 ·d 1 ×2～3w)for 2 times(at 15th month & 24th month after operation).D xylose test, 15 N Gly trace test and 13 C palmitic acid breath test were done before and after each rhGH+Gln treatment.Barium meal follow through examination was carried out at the 15th month, so as to observe the shape and the motility of the residual bowel. ResultsThe study shows that the patient's absorption of 15 N gly and 13 PC palmitic acid were good, and that could be further improved by the rhGH+ Gln treatment. But the patient's absorption of D-xylose was poor,and the treatment had no function on it. At the 15th month,colon had occupied the whole abdomen as a result of adaptive lengthening and enlargement. Barium meal could detained in the gut for 22 hours. Conclusion This rhGH+Gln treatment could rapidly improve the adaptation in absorption in patient after total small bowel resection,we also observed in this study that the nutrients was absorbed in the patient's colon.

关 键 词：全小肠切除 生长激素 谷氨酰胺 吸收 

分 类 号：R459[医药卫生—治疗学]