合理全肠外营养对壶腹周围癌术后作用的研究

目的 观察全肠外营养(TPN)对壶腹周围癌术后支持治疗的影响.方法 选择于我院行胰和十二指肠切除术后TPN治疗的壶腹周围癌患者42例.观察患者术前1 d,术后3、7、10 d的肝功能和营养指标变化.结果 术后10 d总蛋白(TP)、前白蛋白(PA)、纤维结合蛋白(FN)、转铁蛋白(TR)均恢复到术前1 d水平(P＞0.05);术后10 d除间接胆红素(IBIL)外,丙酸氨转氨酶(ALT)、天门氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)等肝功能指标均较术前1 d显著下降(P＜0.05).结论 合理的TPN支持治疗能够显著改善患者术后肝功能和营养状况;TP、PA、FN、ALB等指标可以作为TPN支持治疗效果观测的敏感指标.

The study on periampullary carcinoma patients for TPN therapy

Objective To observe the effect of TPN in the periampullary carcinoma after pancreaticoduodenectomy.Methods Forty-two patients underwent pancreaticoduodenectomy were studied. The liver function and nutrition indices were measured respectively on four time points: preoperative day 1(POD1), postoperative day 4(POD4), postoperative day 7(POD7) and postoperative day 10(POD10).Results There was no difference between POD1 and POD10 in TP,ALB,PA,FN,TR(P>0.05).ALT,AST,ALP,GGT,TBIL, DBIL and TBA were significantly lower than their preoperative levels when POD1 and POD 10 were compared(P<0.05).Conclusions PN is a safe and effective way for the patients after pancreaticoduodenectomy.