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目的:探讨恶性梗阻性黄疸病人减黄术后低氮低热量肠外营养支持对机体代谢功能和免疫功能的影响。方法:将60例恶性梗阻性黄疸病人分为低氮低热量肠外营养组(A组)和普通肠外营养支持组(B组),每组30例。采用不同方法解除梗阻性黄疸2 d后行肠外营养支持5 d。观察肝功能、血脂、胆汁酸、营养指标和体液免疫、细胞免疫功能的变化。结果:全部病人胆道梗阻解除后均能耐受肠外营养支持,A组病人转氨酶、胆红素和胆汁酸水平明显下降,营养指标好转,血脂代谢改善,体液免疫和细胞免疫功能提高。结论:恶性梗阻性黄疸病人胆道梗阻解除后,肠外营养是一种安全的临床营养支持过渡手段,低氮低热量的代谢支持,对机体代谢功能和免疫功能恢复具有正相关性。
Objective: To investigate the effect of low-nitrogen and low-calorie parenteral nutrition on the metabolism and immune function in patients with malignant obstructive jaundice after reduction of yellowing. Methods: Sixty patients with malignant obstructive jaundice were divided into low-nitrogen and low-calorie parenteral nutrition group (group A) and ordinary parenteral nutrition support group (group B), 30 cases in each group. Different methods were used to relieve obstructive jaundice 2 days after parenteral nutrition support 5 d. Observe the changes of liver function, blood lipid, bile acid, nutrition index and humoral immunity and cellular immune function. Results: All patients were able to tolerate parenteral nutrition after biliary obstruction was relieved. A group of patients with transaminase, bilirubin and bile acid levels decreased significantly, nutritional indicators improved, lipid metabolism improved, humoral and cellular immune function improved. Conclusion: After the biliary obstruction is relieved in patients with malignant obstructive jaundice, parenteral nutrition is a safe transitional means of clinical nutrition support. The metabolic support of low-nitrogen and low-calorie has a positive correlation with the recovery of the body’s metabolism and immune function.