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目的 探讨Hepa氨基酸溶液对非肝硬化和肝硬化肝癌病人行肝切除术后肠外营养的应用价值。 方法 2 0 0 2年 2～ 5月对 2 2例肝癌病人行肝切除术 ,术后接受含有Hepa氨基酸溶液的肠外营养 6d ,根据是否合并肝硬化分为两组 ,非肝硬化组 7例 ,肝硬化组 15例。术前和术后第 7天抽血测定肝功能、血糖、前白蛋白、转铁蛋白和CD3 、CD4、CD8、CD56。结果 术后第 7天 ,非肝硬化组血清AST、ALT比肝硬化组恢复快 ,但血清ALP、TBIL比肝硬化组高 ,且肝硬化组血清ALB明显高于非肝硬化组 ;血清前白蛋白 ,转铁蛋白水平均降低 ,但非肝硬化组降低更明显 ;非肝硬化组外周血CD56降低明显。结论 Hepa氨基酸溶液更适合用于肝硬化肝癌术后的肠外营养
Objective To investigate the value of Hepa amino acid solution in postoperative hepatectomy for non-cirrhosis and cirrhosis of liver cancer. Methods Twenty-two patients with hepatocellular carcinoma underwent hepatectomy from February to May in 2002. The patients were given parenteral nutrition containing Hepa amino acid solution for 6 days after operation. The patients were divided into two groups according to whether they had cirrhosis or not, and 7 patients without cirrhosis , Cirrhosis group of 15 cases. Liver function, blood glucose, prealbumin, transferrin, and CD3, CD4, CD8, and CD56 were measured preoperatively and on the seventh postoperative day. Results Serum AST and ALT in non-cirrhosis group recovered faster than that in cirrhosis group on the 7th day after surgery, but serum ALP and TBIL levels were higher than those in cirrhosis group and serum ALB in cirrhosis group was significantly higher than that in non-cirrhosis group. Protein and transferrin levels were lower, but the non-cirrhosis group decreased more obviously; non-cirrhosis group decreased significantly in peripheral blood CD56. Conclusion Hepa amino acid solution is more suitable for postoperative parenteral nutrition in patients with liver cirrhosis