肝硬化大鼠肝切除术后不同营养支持途径的对比研究  

Comparative study on posthepatectomy different nutritional support routes in cirrhotic rats

作　　者：罗时敏[1] 曹杰[2] 罗建威[1] 谭明华[2] 

机构地区：[1]广州市第一人民医院综合外科,510180 [2]广州市第一人民医院普通外科,510180

出　　处：《中华肝胆外科杂志》2008年第10期724-727,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：本课题受广东省医学科学技术研究基金项目（A2007490）、广州市医药卫生科技项目（2006YB-016）和广州市科技攻关计划项目（200523E0181）资助

摘　　要：目的探讨肝硬化大鼠肝切除术后不同营养支持途径的作用。方法6只正常大鼠作为正常对照组，30只肝硬化大鼠随机分为术前组6只，肝切除＋颈内静脉插管术后1d组6只，肝切除＋颈内静脉插管术后行PN5d组6只，肝切除＋胃造瘘术后1d组6只，肝切除＋胃造瘘术后行EN5d组6只。测大鼠肝功能、免疫功能、炎症反应和脂质过氧化指标。结果与PN5d组比较，EN5d组血清AST、ALT、ALP显著下降（P〈O．05），血清ALB、IGF-l显著升高（P〈0．05），外周血CD3^＋、CD4^＋、CD4^＋／CD8^＋显著升高（P〈0．05），血清IL-6、IFN-γ、TNF—α、MDA显著下降（P〈0．05），血清SOD活性显著升高（P〈0．05）。结论EN可以加快肝硬化大鼠肝切除术后肝功能的恢复，避免胆汁淤积，促进肝脏蛋白合成，改善术后免疫功能低下，减轻炎症反应和脂质过氧化损伤。Objective To explore the role of posthepatectomy different support routes in cirrhotic rats. Methods A total of 6 normal rats severed as normal group, 30 rats with liver cirrhosis were randomly divided into pre-operation group （n 6）, posthepatectomy with jugular vein catheter 1 day group （n=6）, post-operation PN 5 day group （n=6）, posthepatectomy with gastrostomy 1 day group （n=6）, post-operation EN 5 day group （n=6）. Liver function, immunological function, inflammatory responses, and lipid peroxidation were determined. Results Compared with the PN 5 day group, serum AST, ALT and ALP were lower（P〈0. 05）, serum ALB and IGF 1 were higher（P〈 0.05）, the peripheral blood CD3^＋ , CD4^＋ and CD4^＋/CD8^＋ ratio were higher（P〈0.05）, serum IL-6, IFN-γ, TNF-α and MDA content were lower（P〈0.05）, serum SOD activity was higher（P〈0.05） in the EN 5 day group. Conclusion Posthepatectomy enteral nutrition in cirrhotic rats can speed up liver function recovery, prevent cholestasis, promote liver protein synthesis, ameliorate the damage of immunological function and reduce inflammatory responses and lipid peroxidation damage.

关 键 词：肝硬化 肝切除术 肠外营养 肠内营养 

分 类 号：R686[医药卫生—骨科学]