摘要
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 study the tolerance of lipid emulsion infusion in patients with severe pancrea titis. Method 33 patients with severe pancreatitis were prospectively studied. Among them, 27 cases with normal basal serum triglyceride (TG) levels were randomly divided into A、B and C groups, the other 6 cases with hypertriglyceridemia were allotted to group D. In group A, each was supplied 800～1000kcal/d by glucose as sole fuel source, both group B and C received glucose and lipid emulsion as dual calories substrates (the fat calories account for 40 per cent of total calories in group B and 50 per cent in group C, respectively). The constitution of caloric substrates in group D depended on the levels of serum TG and glucose. The tolerant ability of lipid emulsion infusion was investigated by the fat clearance test.Results The tolerant abilities were good in group B and C under the condition of 65.0～80.0g/d fat infusion. In group D, the fat clearance tests were positive in five cases with serum TG>4.06mmol/L and fasting serum lactescent, another case was weakly positive with serum TG being 3.14mmol/L and clear fasting serum. Conclusion ① For severe pancreatitis patients with normal serum TG levels, infusion of fat 65.0～80.0g/d is tolerable. ② For those with hypertriglyceridemia, whether to use, or not to use lipid emulsion depends on the abnormal of basal serum TG level and whether fasting lactescent serum is present.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1999年第1期35-37,共3页
Chinese Journal of Digestion
关键词
胰腺炎
胃肠外营养
甘油三酯
脂肪乳剂
Pancreatitis Parenteral nutrition Hypertriglyceridemia Fat emulsion Triglycerids
