中-长链脂肪乳剂与长链脂肪乳剂在静脉营养中的疗效比较

１９９３年１０月至１９９４年２月对中－长链脂肪乳剂（实验组，ｎ＝４０）和长链脂肪乳剂（对照组，ｎ＝３０）在静脉营养中的疗效进行了对比观察。从术后第１天起，除从周围静脉输注必需液体外，每日静滴中－长链或长链脂肪乳剂５００～１０００ｍｌ，连续３～５天。监测项目包括血压、脉搏、呼吸、体温、血红蛋白、白细胞、肝肾功能、血甘油三酯及血胆固醇。结果显示：两组均无全身反应；在输脂肪乳剂后６小时，两组血甘油三酯含量均明显升高，并于１２小时时达峰值，１６小时时已明显下降，但对照组明显高于实验组（Ｐ＜０．０５），２４小时时仍维持较高水平。由此表明，中－长链脂肪乳剂较易从血清中清除；中链甘油三酯能快速进入线粒体被氧化供能，不依赖内毒碱的转运，能经肝脏生成更多的酮体，极少再脂化为脂肪贮存起来。

COMPARISON OF THERAPEUTIC EFFECTS BETWEEN LIPOFUNDIN AND INTRALIPID IN TOTAL PARENTERAL NUTRITION

Seventy patients randomly underwent total parenteral nutrition including either 10% Intralipid (30 cases) or 10% Lipofundin (40 cases), starting from the first postoperative day through the 5th day. Blood pressure, pulse, respiration, temperature, hemoglubin, leukocyte' hepatic and renal function, triglycerides, serum cholestrol were monitored, It was found that medium-chain triglycerides (MCT) based fat emulsion was tolerated by the patients without any side effects. The study showed that levels of triglycerides increased during MCT or long-chain triglycerided (LCT) based fat emulsion infusion, markedly dropped within 16 hours on cessation of MCT infusion, but returned to normal 24 hours after cessation of infusion LCT, indicating good clearance of MCT. The results also showed that bile could not be retarded by MCT.