富含支链氨基酸的氨基酸配方对胃肠外科手术创伤患者的营养支持效果

目的 观察富含支链氨基酸（BCAA）的氨基酸配方对胃肠外科手术创伤患的营养支持效果。方法 按随机、前瞻、单盲、对照原则,将40例胃肠外科中等以上手术后成年患分为两组;研究组（富含BCAA组,20例）和对照组（复方氨基酸注射液,20例）,术后第2d开始,连续6d,采用全营养混合液通过周围或中心静脉输注,等氮等热卡,每日输注时间不少于12h,同时留24h尿测氮平衡,术前第1d、第7d抽静脉血,观察两组患的血氨基酸谱、血总蛋白、白蛋白、前白蛋白、转铁蛋白、纤维连接蛋白。结果 研究组较对照组早2d恢复正氮平衡,且优于对照组（P=0.002),血总蛋白、白蛋白下降明显低于对照组（P=0.013),缬氨酸浓度明显高于对照组（P=0.026),精氨酸浓度下降明显低于对照组（P=0.041)。结论 富含BCAA的氨基酸配方更适合胃肠外科手术创伤患的营养支持,有利于病情恢复。

Effect of the formula of amino acid enriched branch chain amino acid on nutritional support in postoperative traumatic patients

Objective To investigate the effect of the formula of amino acid enriched branch chain amino acid(BCAA) on nutritional support in postoperative traumatic patients.Methods According to prospective,randomized,single blind and controlled rule,40 adult patients after abdominal moderate or large operation were randomized to receive parenteral nutrition with either amino acid enriched BCAA or amino acid(18 F).From the second day after operation,total parenteral nutrition was infused to the patients with equal calorie and equal nitrogen by central or periphral vein for 6 days , within more than 12 hours per day.Meanwhile,nitrogen balance was monitored by collecting urine in 24 hours for 6 days. The indices were investigated such as amino acid patterns,serum levels of total protein, albumin,prealbumin ,transferrin , and fibronectin.Results The positive nitrogen balance in the group with BCAA was got two days earlier than the group with amino acid (18 F)(P=0 002).The decreased serum levels of total protein,albumin were lower(P=0 013),the concentration of Arginine decreased(P=0 026) and the concentration of Valine increased(P=0 041) more significantly than the control group.Conclutions The formula of amino acid enriched BCAA can improve the nutritional status,accelarate the recovery of postoperative traumatic patients.