营养治疗在老年急性胰腺炎伴高脂血症患者中的意义  

Significance of nutritional treatment in aged patients with acute pancreatitis following hyperlipidemia

作　　者：秦朝晖[1] 程爱群[1] 袁祖荣[1] 陆琪[1] 

机构地区：[1]复旦大学附属华东医院普外科,上海200040

出　　处：《老年医学与保健》2007年第1期33-36,共4页Geriatrics & Health Care

摘　　要：目的比较肠内、肠外营养联合应用和单独肠外营养对老年急性胰腺炎伴高脂血症患者治疗过程中的营养、淀粉酶及血液流变学的影响。方法将40例老年急性胰腺炎伴高脂血症的患者随机分为两组:肠内、肠外营养联合应用(EN+PN)组和肠外营养(TPN)组,每组20例。入院后,即开始予以等热量、等氮量的营养支持1周,检测入院后第1天和第8天的营养指标以及淀粉酶、血液流变学指标。结果两组病人入院后第8天的营养指标均较入院第1天下降(P<0.05),两组间差异有统计学意义。两组病人的血浆白蛋白水平均下降,但TPN组下降更为明显,组间比较有统计学意义(P<0.05)。血、尿淀粉酶亦有下降(P<0.01),但两组间差异无统计学意义。胆固醇、甘油三酯、血粘度、红细胞聚集指数等均有下降(P<0.05)。结论在老年急性胰腺炎伴高脂血症的病人中,EN或PN均不能避免机体的分解代谢状态。适量应用中-长链脂肪乳剂并不加重高脂血症。随着急性胰腺炎病情的逐渐缓解,EN、PN均能使高脂血症、血液流变学指标得到改善。Objective To evaluate the effect of enteral nutrition（EN） and parenteral nutritional（PN） on nutritional stags and hemorrheology of the aged patients with acute pancreatitis（AP） following hyperlipidemia. Methods Fourty aged patient with AP following hyperlipidemia were randomly assigned to 2 groups： （1）EN＋PN group（n=20）.（2）PN group（n=20）. Isonitrogenous nutritional support was performed from the day after hospitalization and was maintained for one week.Parameters of nutritional ,immunal ,amylase and bemorrbeologic statuses were measured before and after nutritional support. Results Parameters of nutrion decreased significantly in both groups, but without significant difference.Tbe plasma albumin concentration decreased significantly in two groups and more in TPN group（P〈0.05）.Amylase in blood and urine were also decreased significantly（P〈0.01）, but without significant difference. Levels of cholesterol, triglyceride, blood viscosity, erythrecyte aggregation exponent were decreasod（（P〈0.05））. Conclusions Neither EN nor PN can avoid catabolism in aged patients with acute pancreatitis following hyperlipidemia. Moderate application with medium/long chain lipid emulsion does not aggravate hypedipidemia.Both EN and PN could ameliorate the parameter of hyperlipidemia and bemorrbeologic accompanying with the recover of acute panreatitis.

关 键 词：高脂血症 胰腺炎 营养支持 血液流变学 

分 类 号：R576[医药卫生—消化系统] R589.2[医药卫生—内科学] R459.3[医药卫生—临床医学]