中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (02): 114-116.

• 论著 • 上一篇    下一篇

强化肠外营养治疗对外科重症病人影响的研究

佟大年，杨    俊，秦环龙   

  1. 上海交通大学附属第六人民医院外科，上海200233
  • 出版日期:2010-02-01 发布日期:2010-03-11

  • Online:2010-02-01 Published:2010-03-11

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摘要：

目的    探讨生长激素（GH）联合谷氨酰胺（Gln）的强化肠外营养（PN）治疗对外科重症病人机体组成及血清氨基酸谱变化的影响。方法    对2008年2~8月上海交通大学附属第六人民医院强化PN治疗的资料进行分析。选择30例外科重症病人观察PN前后人体组成：非脂群（FFM）、体脂群（FM）、细胞外水/总体水（ECW/TBW）比率以及血清氨基酸谱的变化。所有数据采用均数±标准差表示，利用SPSS11.5统计软件分析。结果    强化营养治疗较常规PN 的FFM增加， FM减少，且ECW/TBW的比率维持不变；血清中多种氨基酸含量降低，Gln含量升高。 结论    单纯PN支持，短期内较难纠正其骨骼肌的大量降解和体内液体的异常分布。强化营养治疗可以增加细胞对血中游离氨基酸的摄取和利用，改善细胞外液与细胞内液间的液体平衡。

关键词: 外科重症病人, 生长激素, 谷氨酰胺, 血清氨基酸谱

Abstract:

The effect of the strengthened nutritional support to body composition and amino acid patterns for the surgical critical patients        TONG Da-nian, YANG Jun, QIN Huan-long.  Department of Surgery, the Affiliated No.6 People’s Hospital of Shanghai Jiaotong University, Shanghai 200233，China
Corresponding author：QIN Huan-long，E-mail：hlqin@sjtu.edu.cn
Abstract    Objective    To evaluate the clinical effects of parenteral nutrition (PN) combined with recombinant human growth hormone (rhGH) and glutamine (Gln) on surgical critical patients. Methods    Thirty surgical critical patients with the APACHE Ⅱ from 10 to 20 were selected. Body compositions （Fat mass，fat-free mass，the ratio of extracellular water and total body water） and serum amino acid patterns were assessed. All data were collected down in the form as mean ± standard deviation and analyzed with SPSS 11.5 for Windows.  Results    Fat mass decreased and fat-free mass increased, the serum level of amino acids decreased, the serum level of glutamine increased in strengthened group as compared with PN group. Conclusion    PN+rhGH+Gln for the strengthened nutritional support in surgical critical patients might be beneficial to the protein synthesis from amino acids by skeletal muscles, and improve the balance of cell’s 
liquid. So the strengthened nutritional support is very important for the surgical critical patients, especially for their rehabilitation and prognosis.

Key words: surgical critical patient, growth hormone, glutamine, serum amino acid patterns