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选择肝硬变门脉高压病人15例,随机分为两组:长链脂肪乳剂组(n=8,简称LCT组),中/长链脂肪乳剂组(n=7,简称MCT组)。两组供氮每天每千克体重0.15~0.2g,非蛋白质热卡为每天每千克体重20~25kcal。LCT组脂肪能源由20%-Intralipid提供,MCT组由20%-LiPofundinMCT/LCT提供。糖脂供能比为2:1。在术前、术后1、4、7天,测定肝、肾功能及胆红素血脂代谢变化。结果表明,术后第1天胆红素明显升高,但MCT组胆红素随后显著下降,I-CT组下降速度慢于MCT组,PM0.05,两组对肝脏功能无明显影响。整个实验过程中甘油三酯无明显变化。提示门脉高压术后PN使用LCT或MCT/LCT乳剂基本上是安全有效的。MCT/LCT乳剂显示出更好的优越性。
Fifteen patients with cirrhotic portal hypertension were randomly divided into two groups: long-chain fat emulsion group (n = 8, abbreviated as LCT group) and medium / long-chain fat emulsion group (n = 7, MCT group for short). Two groups of nitrogen per day per kilogram of body weight 0.15 ~ 0.2g, non-protein heat card per kilogram of body weight per day 20 ~ 25kcal. The LCT group was provided with 20% -Intralipid fat energy and the MCT group with 20% -LiPofundinMCT / LCT. Glycolipid to energy ratio of 2: 1. Preoperative and postoperative 1,4,7 days, liver and kidney function and bilirubin lipid metabolism were measured. The results showed that bilirubin was obviously increased on the first day after operation, but the bilirubin level in MCT group was significantly lower than that in MCT group and PM0.05 group. The two groups had no significant effect on liver function. There was no significant change in triglycerides throughout the experiment. It is basically safe and effective to use PNT or MCT / LCT emulsion for PN postoperative portal hypertension. MCT / LCT emulsions showed better superiority.