全肠外营养所致淤胆的研究与进展

全肠外营养在临床治疗中发挥着重要作用，但胆汁淤积的发生严重限制了它的应用。经过多年研究，目前对ＴＰＮ淤胆已有一定程度上的认识，但还不够深入，其具体发病机制仍未能完全阐明。ＴＰＮ淤胆的诊断尚无权威性的统一标准，多数人赞同应综合临床症状，生理，组织病理，临床化学等多项指标综合评估。ＴＰＮ淤胆的病变部位研究较少，相关致病因素研究较多，感染、回肠疾病，早产等原发病可单独或协同导致淤胆，禁食及营养液中葡萄糖

Total parenteral nutrition-indeced cholestasis

Total parenteral nutrition has played an important role in clinical therapy, but it was badly restricted for application by the cholestasis. TPNinduced cholestasis has been recognized in a certain extent through recent years.Its detailed pathogenesis has not been clarified yet. There isn't common criterion for the diagnosis of TPNindeced cholestasis at present. The majority of people agreed that it should be judged by the combination of clinical symptom, physiology, pathology and chemical analysis. There was little study about the pathologic position of TPNinduced cholestasis. Some primary disease, such as sepsis, ileum disease and premature delivery may solely or cooperatively influence the cholestasis. Fasting and the problem of TPN solution such as quality, quantity and proportion of glucose, lipid emulsion, amino acid, vitamin and trace element have been proved to be associated with the cholestasis. Promoting the contraction of cholecyst, improving the composition of TNA and using the method of circulation infusion were the measures to eliminate the cholestasis, but the effect was not very satisfied.