[术后早期静脉注射脂肪乳剂]。

B Weidler, H J Prinzler, B von Bormann, E Lohmann, K H Muhrer, G Hempelmann
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引用次数: 0

摘要

脂肪乳剂的肠外应用已被证实在长期人工营养中是有用的,特别是在脱离呼吸机期间。为了确定这些优势是否也可以在术后立即非通气患者中得到证明,我们研究了碳水化合物与新型脂肪乳的替代。30名患者被随机分配到三种不同的营养方案。各组的热量和氮补充量相同,而碳水化合物和脂肪含量不同。第一组:仅含碳水化合物(作为热量来源),第二组:高脂肪负荷(3 g/kg/天),第三组:中等脂肪负荷(1.5 g/kg/天)。评估常规实验室参数以及酸碱状态和脂肪代谢。虽然大多数常规参数在两组之间没有显著差异,但血清甘油三酯水平在II组最高,但从未超过280 mg/dl (-x)。使用方案III,氮平衡和蛋白质代谢显著改善,因此记录了中等脂肪剂量在术后立即阶段的有益作用。肠外营养结合氨基酸,碳水化合物和脂肪乳似乎是最佳的术后方案,即使在没有通气支持的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Parenteral use of a fat emulsion in the early postoperative period].

Parenteral application of fat emulsions has been established as useful in long term artificial nutrition especially during weaning off the ventilator. In order to ascertain whether these advantages can also be proved in nonventilated patients in the immediate postoperative phase, alternatively carbohydrates versus a new fat emulsion were investigated. 30 patients were randomly allocated to three different nutrition regimens. The caloric and nitrogen supplementation was identical for all groups, while the carbohydrate and fat content was different. Group I: only carbohydrates (as caloric source), group II: high fat load (3 g/kg/day), group III: medium fat dosage (1.5 g/kg/day). Routine laboratory parameters as well as acid-base-status and fat metabolism were evaluated. While most of the routine parameters were not significantly different between the groups, triglyceride levels in serum were highest in group II but never exceeding 280 mg/dl (-x). Nitrogen balance as well as protein metabolism were significantly improved using regimen III, thus documenting the beneficial effect of a medium fat dosage in the immediate postoperative phase. Parenteral nutrition combining amino acids, carbohydrates and a fat emulsion seems to be the optimal postoperative regimen even in patients without ventilatory support.

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