低氮低热量肠外营养在肝叶切除患者术后的应用  

作　　者：陈剑 钟耀星 余莲花 邹道发 孙秋冬 

机构地区：[1]修水县第一人民医院肝胆外科,江西332400

出　　处：《当代医学》2016年第32期4-6,共3页Contemporary Medicine

基　　金：九江市科技支撑计划项目(20150102)

摘　　要：目的探讨低氮低热量肠外营养对肝叶切除术后患者的影响。方法将预实施肝叶切除患者60例,随机分为试验组和对照组,各30例,术后分别应用低氮低热量肠外营养和传统肠外营养支持。比较2组患者血浆白蛋白(ALB)、前白蛋白(Pre-ALB)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、术后住院天数及住院费用的变化。结果 (1)手术前后ALB对照组:术前(37.6±3.7),术后3 d(34.2±3.4);试验组:术前(35.7±4.2),术后3 d(35.1±2.8);手术前后Pre-ALB对照组:术前(0.25±0.04),术后3 d(0.23±0.01);试验组:术前(0.26±0.08),术后3 d(0.27±0.03);术后试验组ALB、Pre-ALB均高于对照组,2组蛋白总体水平较术前均有下降(P<0.05);(2)手术前后AST对照组:术前(125.0±13.5),术后3 d(150±24);试验组:术前(121±15),术后3 d(120±18);手术前后ALT对照组:术前(99.0±15.5),术后3 d(70.0±8.8);试验组:术前(105±12),术后3 d(60.0±10.5)。术后2组患者AST、ALT均较术前升高(P<0.05),试验组转氨酶水平低于对照组,但差异无统计学意义;(3)2组住院天数:对照组(15±4)d,试验组(13±2)d;2组住院费用:对照组(19 306.0±526.6)元,试验组(18 047.0±415.3)元。试验组术后住院天数和住院费用明显低于对照组(P<0.05)。结论实施肝叶切除患者术后低氮低热量肠外营养支持有利于改善营养状态,减少术后住院天数和住院费用。Objective To observe the effects of hypocaloric andhyponitrogenic parenteral nutrition on patients after hepatolobectomy. Methods Six typatients after hepatolobectomy were randomly divided into control group （n=30） and study group （n=30）, treated with hypocaloric and hyponitrogenic parenteral nutrition, and traditional parenteral nutrition respectively.serumalbumin （ALB）, prealbumin （Pre-ALB）, glutamic oxaloacetic transaminase （AST）, glutamic pyruvic transaminase （ALT）, postoperative hospital stay, total hospitalization expenditure were analyzed. Results （1）Perioperative period ALB the control group： preoperative （37.6±3.7）, postoperative 3d （34.2±3.4）; the experimental group：preoperative （35.7±4.2）, postoperative 3d （35.1±2.8）;perioperative period Pre-ALB the control group：preoperative （0.25±0.04）, postoperative 3d （0.23±0.01）; the experimental group： preoperative （0.26±0.08）, postoperative 3d （0.27±0.03）; The experimental group ALB, Pre-ALB were higher than the control group after treatment, the overall level of serum proteins were decreased compared with preoperative （P〈0.05）; （2）Perioperative period AST the control group： preoperative （125.0±13.5）, postoperative 3d （150±24）; the experimental group： preoperative （121±15）, postoperative 3d （120±18）; perioperative period ALT the control group： preoperative （99.0±15.5）, postoperative 3d （70.0±8.8）; the experimental group： preoperative （105±12）, postoperative 3d （60.0±10.5）. Postoperative AST, ALT were increased compared with preoperative （P〈0.05）, the experimental group transaminase levels lower than the control group, but the difference was not statistically significant; （3）Postoperative hospital stay： the control group （15±4）d, the experimental group （13±2）d; total hospitalization expenditure： the control group （19 306.0±526.6）, the experimental group （18 047.0±415.3）. postoperative hospital stay

关 键 词：低氮 低热量 肠外营养 肝叶切除 

分 类 号：R657.3[医药卫生—外科学]