重组人生长激素联合低氮低热卡肠外营养支持对胃肠术后低蛋白血症的作用  

Effect of rhGH combined with hypocalore and lower nitrogen parenteral nutrition support on postoperative hypoalbuminemiaafter gastrointestinal surgery

作　　者：何霖 程模 杨培洪 蒋绪敬 舒宁波 周军 彭杨 黄华英 游必波 IHE Lin;CHENG Mo;YANG Pei-hong;JIANG Xur-jing;SHU Ning-bo;ZHOU Jun;PENG Yang;HUANG Hua-ying;YOU Bi-bo(Deartment of Pharmacy,Chongqing Dinjiang County People's Hospital,Dinjiang 408300,Chongqing;Deartment of Gastrointestinal Surgery,Chongqing Dinjiang County People's Hospital,Dinjiang 408300,Chongqing)

机构地区：[1]重庆市垫江县人民医院药剂科,重庆垫江408300 [2]重庆市垫江县人民医院普外科胃肠病区,重庆垫江408300

出　　处：《中药与临床》2020年第3期39-42,共4页Pharmacy and Clinics of Chinese Materia Medica

基　　金：重庆市卫生计生委2017年医学科研项目(编号:2017MSXM192)。

摘　　要：目的:探讨重组人生长激素(rhGH)联合低氮低热卡肠外营养支持(PN)对胃肠术后低蛋白血症患者的作用。方法:应用前瞻性随机对照方法,将40例胃肠术后低蛋白血症的患者,按入组的顺序根据随机数字表法随机分配到实验组和对照组,rhGH联合低氮低热卡PN组(n=20)为实验组,低氮低热卡PN组(n=20)为对照组。两组患者从术后第一天开始每日经肠外营养支持给予非蛋白热量为25KCal/kg/d,蛋白质为1.5g/kg/d,共7天。实验组的受试者从术后第一天开始给予rhGH 0.15IU/kg肌肉注射每天1次,共7d。研究比较两组患者术后蛋白代谢指标(血浆白蛋白、前白蛋白、总蛋白)、血糖、甘油三酯、及并发症。结果:与对照组比较,实验组治疗后4d、7d蛋白质代谢指标明显改善,术后并.发症的发生率明显降低(P<0.05)。而两组血糖、甘油三酯在治疗前4d、7d监测显示,两组间差异无统计学意义(P>0.05)。结论:rhGH联合低氮低热卡PN可显著提高胃肠术后病人血浆蛋白浓度,对术后低蛋白血症有明显的治疗作用,降低术后并发症发生率。Objective:To investigate effect of rhGH combined with hypocalore and lower nitrogen parenteral nutrition(PN)support on postoperative hypoalbuminemia after gastrointestinal surgery.Method:A prospective randomized control trial was designed.Forty patients suffered from hypoalbuminemia after gastrointestinal surgery were randomly divided into the experimental group and the control group using random number form.RhGH combined with hypocalore and low nitrogen PN group(n=20)was set as experimental group.Hypocalore and low nitrogen PN group(n=20)was set as control group.Two groups were given 25 KCalkg/d non-protein calories daily through PN,and the protein was1.5 g/kg/d for 7 days after operation.The experimental group were intramuscularly injected with rhGH 0.15 IU/kg daily for 7 days after operation.Postoperative protein metabolism indexes(plasma albumin,pre-albumin,total protein),blood sugar,triglyceride and complications were compared between the two groups.Result:Indexes of the protein metabolism in the experimental group was significantly improved on the 4th and 7th days after treatment(P<0.05),and the incidence of postoperative complications in the experimental group was signifcantly lower than that in the control group (P<0.05).The blood sugar and triglyceride levels were similar between the two groups(P>0.05)on the 4th and 7th days after treatment.Conclusion:RhGH combined with hypocalore and low nitrogen can significantly increase the plasma protein concentration of patients after gastrointestinal surgery.It has obvious therapeutic effect on hypoproteinemia after surgery and reduces the incidence of postoperative complications.

关 键 词：重组人生长激素 肠外营养 低蛋白血症 胃肠手术 

分 类 号：R57[医药卫生—消化系统]