高支链氨基酸肠外营养支持对全胃切除术后患者的营养支持效果  

Effect of the formula of amino acid enriched branch chain amino acid on nutritional support in postoperative total gastrectomy patients

作　　者：欧阳一鸣[1] 王昆华[1] 龚昆梅[1] 张勇学[1] 

机构地区：[1]云南省第一人民医院普通外科,云南昆明650032

出　　处：《中国医疗前沿（学术版）》2008年第9期17-19,共3页China Healthcare Innovation

摘　　要：目的观察富含支链氨基酸(BCAA)的氨基酸配方对全胃切除术后患者的营养支持效果。方法按随机、前瞻、单盲、对照原则,将40例行全胃切除术患者分为两组:研究组(富含BCAA组.20例)和对照组(复方氨基酸注射液组,20例),术后第1天开始.连续6天.采用全营养混和液通过周围或中心静脉输注等氮、等热卡.每天输注时间不少于12小时.同时留24小时尿测氮平衡。术前、术后第3天和第7天抽静脉血,测两组患者的血清总蛋白、白蛋白、前白蛋白、转铁蛋白和C-反应蛋白。结果研究组术后第2天转为正氮平衡,对照组术后第6天转为正氮平衡,术后第3天时,两组之间的差异非常显着(P<0.01);研究组累积氮平衡为正氮平衡,对照组累积氮平衡为负氮平衡,两组之间差异非常显着(P<0.01)。术后第3天,研究组血浆前白蛋白浓度明显高于对照组(P<0.05);术后第7天,研究组血浆前白蛋白、转铁蛋白浓度显着高于对照组(P<0.01)。结论富含BCAA的氨基酸配方更适合全胃切除术后患者的营养支持,有利于病情恢复。Objective To investigate the effect of the formula of amine acid enriched branch chain amino acid （BCAA）on nutritional support in postoperative total gastrectemy patients. Methods According to prospective,randomized, single-blind and controlled rule. 40 adult patients after total gastrectomy were randomized to receive parenteral nutrition with either amino acid enriched BCAA or amino acid（18-F ）.From thefirst day after operation, total parenteral nutrition was infused to the patients with equal calorie and equal nitrogen by central or periphral vein for 6 days ,within more than 12 hours per day. Meanwhile,nitrogen balance was monitored by collecting urine in 24 hours for 6 days The indices were investigated such as serum levels of total protein, albumin, prealbumin , transferrin and C-reactive protein. Results The positive nitrogen balance in patients in the experimental group was got on the second postoperative day, 4day earlier than that in the control group, and the levels of nitrogen balance on the third postoperative day were varied significantly between the two groups （P〈0.01）. The cumulative nitrogen balance was positive in the experimental group while negative in the control group （P〈0.01）.After 7dayTPN, serum levels of prealbumin （P〈0.01）aud transferrin （P〈0.01） in the experimental group increased more significantly than that in the control group. Conclusion The formula of amino acid enriched BCAA can improve the nutritional status, accelerate the recovery of postoperative total gastrectomy patients.

关 键 词：支链氮基酸 全胃切除术 营养支持 

分 类 号：R656.61[医药卫生—外科学]