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目的探索重症胰腺炎病人对静脉输注脂肪乳剂的耐受性。方法３３例重症胰腺炎病人，其中２７例基础血甘油三酯（ＴＧ）值正常者随机分成Ａ、Ｂ、Ｃ三组，６例基础血ＴＧ值高于正常者列为Ｄ组。各组均给予肠外营养：Ａ组以葡萄糖单能源供能，热卡量为８００～１０００ｋｃａｌ／ｄ；在提供热卡与氮源相同的条件下，Ｂ、Ｃ组均以双能源供能，其糖脂热卡比分别为６∶４及５∶５；Ｄ组肠外营养配方根据血ＴＧ、血糖测定值而定。以脂肪乳剂廓清试验观察对输注脂肪乳剂的耐受性。结果Ｂ、Ｃ组每日输注脂肪６５．０～８０．０ｇ均能耐受；Ｄ组有５例基础血ＴＧ值＞４．０６ｍｍｏｌ／Ｌ，且空腹血清呈乳状，脂肪乳剂廓清试验阳性，１例基础血ＴＧ值为３．１４ｍｍｏｌ／Ｌ，空腹血清不呈乳状，脂肪乳剂廓清试验弱阳性。结论①基础血ＴＧ值正常的胰腺炎病人，每日输注占总热卡４０％～５０％的脂肪乳剂均能耐受；②伴高ＴＧ血症的胰腺炎病人，应根据基础血ＴＧ值增高的程度及是否存在空腹乳状血清，来判断应用、慎用或不用肪脂乳剂。
Objective To explore the tolerance of intravenous fat emulsion in patients with severe acute pancreatitis. Methods Totally 33 patients with severe acute pancreatitis were randomly divided into three groups (A, B and C). 27 patients with normal basal levels of triglyceride (TG) were considered as D group. All groups were given parenteral nutrition: Group A was fed with a single energy source of glucose, with a caloric intake of 800-1000 kcal / d; while both B and C were supplied with dual energy sources under the same heat card and nitrogen source conditions, The glycolipid heat card ratio were 6: 4 and 5: 5; D group parenteral nutrition formula based on blood TG, blood glucose determination may be. The lipid emulsion clearance test was used to observe the tolerance to the infusion of fat emulsion. Results In group B and group C, 65.0-80.0 g of fat per day could be tolerated. In group D, there were 5 cases with basal serum TG> 4.06 mmol / L, and fasting serum was milky, and fat emulsion clearance test was positive. One case of basal blood TG value of 3.14mmol / L, fasting serum is not milky, fat emulsion clearance test weakly positive. Conclusions ① In patients with pancreatitis with normal serum TG value, daily fat emulsion containing 40% ~ 50% of total calories can be tolerated. ② Patients with pancreatic inflammation with high TG serum should be treated according to the basal blood TG value Increase the degree and the presence of fasting serum, to determine the application, with or without fat emulsion.