[围手术期肠外喂养方案范围内脂质乳对氮平衡的影响]。

J Hayungs, V Michalczik, F Borchard, L M Herbertz, W Stock, H Reinauer
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引用次数: 0

摘要

结直肠癌患者术前、术后采用两种不同的等热量方案进行肠外喂养:一组给予高碳水化合物溶液(碳水化合物组),另一组给予碳水化合物联合脂肪乳(脂肪组)。脂肪日剂量限制在1 g脂肪/kg体重/天。这些情况导致了以下结果:在两种方案的患者之间没有观察到蛋白质平衡的显著变化。蛋白质节约效果和短活蛋白的合成具有可比性。输注脂肪乳无代谢并发症。脂肪组的患者得到了充足的必需脂肪酸供应,这是由血液中较高水平的亚油酸所证明的。对手术切除的肝脏样本进行生化和组织学分析,两组的甘油三酯含量相当。脂肪组实质细胞中脂质沉积较少,但网状内皮系统(v. Kupffer细胞)中可见脂滴。因此,脂肪滴在两组中的分布是不同的。不幸的是,在肠外营养结束时,无法进行肝脏脂质沉积分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Effect of lipid emulsions on nitrogen balance within the scope of perioperative parenteral feeding regimens].

Patients with colorectal cancer were parenterally fed before and after surgery by two different isocaloric regimens: One group was infused with high carbohydrate solutions (carbohydrate group), the other group with carbohydrate in combination with fat emulsions (fat group). The daily dose of fat was restricted to 1 g fat/kg BW/day. These conditions led to the following results: No significant changes in the protein balance were observed between the patients of the two regimens. The protein sparing effect and the synthesis of short living proteins were comparable. The infused fat emulsions were utilized without metabolic complications. Patients in the fat group were adequately supplied with essential fatty acids which was documented by the higher level of linolic acid in the blood. The biochemical and histological analysis of the liver samples which were excised on occasion of surgery gave comparable triglyceride content in both groups. In the fat group little lipid deposition was seen in the parenchymal cells but lipid droplets were observed in the reticuloendothelial system (v. Kupffer cells). Thus, distribution of fat droplets is different in the 2 groups. Unfortunately analysis of lipid depositions in the liver at the end of the parenteral nutrition could not be performed.

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