结构脂肪乳剂对腹部中等手术后病人脂肪代谢的影响  

The effect of structolipid and physical mixed MCT/LCT on plasma lipid metabolism of patients after abdominal operation

作　　者：王新颖[1] 李宁[1] 谭力[1] 邹志英[1] 江志伟[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2006年第4期209-211,共3页Parenteral & Enteral Nutrition

摘　　要：目的:观察结构脂肪乳剂(STG)和物理混合的中/长链脂肪乳剂(MCT/LCT)对腹部中等手术后病人脂肪代谢的影响。方法:选择40例腹部中等手术后、需要肠外营养支持至少5 d以上的病人40例,按前瞻、随机、盲法、对照原则分为STG组20例和MCT/LCT组20例。术后第1 d至第5 d两组病人按等氮、等热量进行肠外营养支持。于手术前、术后第1 d营养支持前及术后第6 d的清晨6∶00留取血标本检测三酰甘油和胆固醇。术后第2 d输注前与输注结束时抽取静脉血检测三酰甘油、胆固醇和游离脂肪酸。结果:与术前值相比,两组病人三酰甘油与胆固醇在术后第1 d均明显下降,术后第6 d两组三酰甘油水平又逐渐上升。但与STG组相比,输注物理混合MCT/LCT后,病人的三酰甘油及中链脂肪酸升高幅度更大一些,而STG LCFA的升高要更明显。结论:在对术后病人三酰甘油以及中链脂肪酸的代谢影响等方面,STG影响要小于MCT/LCT;对长链脂肪酸的影响STG要大于物理混合MCT/LCT,这与STG结构特点有关。Objective：To investigate the effect of structolipid and physical mixed MCT/LCT on plasma lipid metabolism of patients after abdominal operation. Methods ： In a randomized cross-cover study, the total parenteral nutrition contained structolipid or physical mixed MCT/LCT was transfused from the first day to the sixth day after operation. The plasma triglyceride and cholesterol were measured before operation,the first and sixth day after operation. The blood was sampled to assay the level of triglyceride,cholesterol and free fat acid before and after transfusion after operation. Results：The plasma triglyceride and cholesterol were dropped after operation and obviously increased after five days of parenteral nutrition. The changes of triglyceride and medium free fatty acids（C8 and C10） were smaller in STG group than those in control. However, the increase of long free fatty acids was larger in STG group than that in control. Conclusion：The effect of structolipid on plasma lipid metabolism of patients after abdominal operation is different from the physical mixed MCT/LCT.

关 键 词：结构脂肪乳剂 中等腹部手术 脂肪代谢 营养支持 

分 类 号：R656[医药卫生—外科学]