结构脂肪乳与中/长链脂肪乳对肝癌患者肝切除术后营养支持的效果比较
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篇名: 结构脂肪乳与中/长链脂肪乳对肝癌患者肝切除术后营养支持的效果比较
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摘要: 目的:比较结构脂肪乳和中/长链脂肪乳对肝癌患者肝切除术后营养支持的效果。方法:选取我院2013年1月-2016年3月原发性肝癌患者100例,按照随机数字表法分为对照组和试验组,各50例。对照组患者给予中/长链脂肪乳注射液(C6~24),试验组患者给予结构脂肪乳注射液(C6~24),剂量以等氮等热量原则计算,通过外周置入中心静脉导管输注,每日16~18 h,连续输注7 d。观察两组患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、前清蛋白(PAB)、白蛋白(ALB)、总胆固醇(TC)、三酰甘油(TAG)、C反应蛋白(CRP)等指标水平,记录住院时间、并发症和不良反应发生情况。结果:治疗前,两组患者上述指标比较,差异均无统计学意义(P>0.05)。治疗第5、7天,两组患者ALT、AST、TBIL水平均明显高于治疗前,但试验组患者ALT、AST、TBIL水平均明显低于对照组,且PAB水平明显高于对照组,差异有统计学意义(P<0.05);治疗第5天,试验组患者TC、TAG、CRP水平明显低于对照组,差异有统计学意义(P<0.05)。试验组患者术后平均住院时间明显短于对照组,差异有统计学意义(P<0.05)。两组患者术后的并发症发生率比较,差异无统计学意义(P>0.05)。两组患者在治疗过程中均未见明显不良反应发生。结论:结构脂肪乳较中/长链脂肪乳可减少肝癌患者肝切除术后的肝脏代谢负担,减轻机体的炎症反应,改善营养状况且安全性好。
ABSTRACT: OBJECTIVE: To compare the efficacy of structured fat emulsion and medium/long chain fat emulsion for nutritional support in liver carcinoma patients after hepatectomy. METHODS: 100 patients from our hospital during Jan. 2013 to Mar. 2016 with primary liver carcinoma were selected and divided into control group and observation group according to random number table, with 50 cases in each group. Control group was given Medium/long chain fat emulsion injection (C6-24), and trial group was given Structured fat emulsion injection (C6-24), by equal nitrogen and equal heat principles, via peripheral inserted central venous catheter, 16-18 h each day, for 7 d. The levels of ALT, AST, TBIL, PAB, ALB, TC, TAG, CRP were observed in 2 groups, and hospitalization time, complication and the occurrence of ADR were also recorded. RESULTS: Before treatment, there was no statistical significance in above indexes between 2 groups (P>0.05). On 5th,7th day of treatment, the levels of ALT, AST and TBIL of 2 groups were significantly higher than before treatment, but the levels of ALT, AST and TBIL of trial groups were significantly lower than those of control group, and the level of PAB of trial group was significantly higher than that of control group, with statistical significance (P<0.05); on 5th day of treatment, the levels of TC, TAG and CRP in trial group were significantly lower than in control group, with statistical significance (P<0.05).  Average postoperative hospitalization time of trial group was significantly shorter than that of control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of complication between 2 groups after surgery (P>0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS: Compared to medium/long chain fat emulsion, structured fat emulsion can relieve the burden of liver metabolism and  inflammation reaction, improve nutritional status in liver carcinoma patients after hepatectomy with good safety.
期刊: 2017年第28卷第2期
作者: 彭娜,吕飞,郭秋霞
AUTHORS: PENG Na,LYU Fei,GUO Qiuxia
关键字: 原发性肝癌;结构脂肪乳;中链脂肪乳;长链脂肪乳;肝切除术;肠外营养
KEYWORDS: Primary liver carcinoma; Structured fat emulsion; Medium chain fat emulsion; Long chain fat emulsion; Hepatectomy; Parenteral nutrition
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