脂肪乳剂Intralipid对全胃切除后病人脂肪酸代谢的影响

本研究评价手术创伤和手术后静脉输入脂肪乳剂后对手术创伤病人脂肪酸代谢的影响.采用气相色谱法分析6例贲门、胃底癌全胃切除病例术前、术后6h,用含Intralipid全胃肠外营养支持后1、3、5、7天及术后8天开始管饲要素饮食至术后14天血浆脂肪酸浓度变化.结果显示术后6h血浆软脂酸、硬脂酸、油酸、亚油酸浓度显著低于术前(P<0.05,P<0.01).全胃肠外营养支持3、5、7天后,血浆硬脂酸、油酸、亚油酸浓度比术后6h显著升高(P<0.05或P<0.01).术后14天血浆油酸、亚油酸浓度仍比术后6h显著升高(P<0.05)但较全胃肠外营养支持3、5、7天有下降趋势.研究证明,手术创伤后,血浆脂肪酸利用致血浆脂肪酸浓度降低,推荐手术后立即应用含Intralipid全胃肠外营养支持.

The effects of intralipid on lipometabolism of the patients with tatal gastrectomy

The purpose of the study is to evaluate the effects of the intravenous fatty emulsion injections on lipometabolism of the patients with the operative injuries after operations. Six cases of gastric carcinoma were studied. Changes of the concentration of free fatty acid in plasma by using gas chromatography were observed in the following times: Pie-total gastrectomy, at six hours after operation, on the 1st, 3rd, 5th 7th day and 8th to/4th day after operation. Patients received parenteral nutrition containing Intralipid from 1st to 7th day and nose-gastric tube feeding from the 8th to 14th day after operation. The results showed that the concentrations of palmitic acid, stearic acid, oleic acid and linoleic acid in plasma of six hours after operation were lower than that of pre-total gastrectomy ( P <0. 05, P <0. 01). The concentrations of stearic acid, oleic acid and linoleic acid in plasma on the 1st, 3rd, 5th, 7th day after operation got notable increase than those of six hours after operation( P <0. 05, P <0. 01). The concentrations of oleic acid and linoleic acid in plasma from the 8th to 14th day increased a little more than those of six hours after operation( P <0. 05). but compared with the level on the 3rd, 5th and 7th day, they tended to decrease. The study illustrated that the free fatty acids in plasma were utilized and decreased after injury so that it was recommended for the patients to receive parenteral nutrition containing the fatty emulsion immediately after injury.