11.4%Novamin与7%Vamin对术后病人蛋白质代谢影响的比较研究

目的：在腹部外科手术后病人肠外营养支持中行复方氨基酸液１１．４％Ｎｏｖａｍｉｎ和７％Ｖａｍｉｎ对蛋白质代谢影响的比较研究。方法：７０例病人术后１～６天进行肠外营养支持，等热量、等氮（非蛋白热量为１０５ｋＪ／ｋｇ·ｄ－１，氮量为０．１５ｇ／ｋｇ·ｄ－１）。随机分成两组，每组３５例。一组氮的供给由１１．４％Ｎｏｖａｍｉｎ提供，另一组则由７％Ｖａｍｉｎ提供。在术前和术后６天营养支持结束后，分别测量体重，测定血浆总蛋白和白蛋白浓度，分析血浆氨基酸谱。术后１～６天每天收集２４尿液和腹腔引流液等其他排出液测定氮量，并计算氮平衡。结果：两组病人术后体重、血浆总蛋白和白蛋白浓度与术前比均有下降，但组间无显著差异。氨基酸谱分析在组间比较无显著差异。氮平衡观察表明，两组术后１～６天累积氮平衡差异显著，１１．４％Ｎｏｖａｍｉｎ组为（－８２．２±２４．７）ｍｇ／ｋｇ体重，７％Ｖａｍｉｎ组为（－１７１．１±２０１．６）ｍｇ／ｋｇ体重，Ｐ＜０．０５。结论：在手术创伤后应用１１．４％Ｎｏ－ｖａｍｉｎ进行肠外营养支持比７％Ｖａｍｉｎ能进一步改善氮平衡

Effect of 11.4%Novamin on protein metabolism in postoper ative patients

Objectives: The study was designed to observe the effect of 11.4%Novamin on protein metabolism in postoperative patients. Methods: 70 cases of patients were randomly divided into two groups and were supported with total parenteral nutrition for 6 days after their abdominal surgery.105 kJ(25 kcal)/(kgd) of nonprotein calorie and 0.15 g/(kgd) of nitrogen were provided in every patient. 11.4%Novamin was used in one group and 7%Vamin was used in another group as control.Body weight,total protein and albumin concentrations and plasma amino acid profile were measured before and after the study.Daily nitrogen output in urine and other drainages was determined and nitrogen balance was calculated during the TPN period. Results:The differences in body weight,total protein and albumin concentrations and amino acid profile were not significant between the two groups.The difference in accumulated nitrogen balance was significant,(-82.224.7)mg/kg body weight in 11.4%Novamin group and (-171.1201.6)mg/kg body weight in 7%Vamin group(P<0.05). Conclusions: The use of 11.4%Novamin in postoperative patients is helpful to further improve the nitrogen balance when compared with 7%Vamin.