术后早期肠内营养支持对心瓣膜置换术患者血浆游离氨基酸的影响

目的了解术后早期肠内营养支持是否有助于维持心瓣膜置换术患者围术期血浆游离氨基酸谱的平衡. 方法采用随机数字表法将47例心瓣膜置换术患者分为普通饮食组和能全力组,用柱前衍生化的反相高效液相色谱法测定其血浆中16种游离氨基酸的含量,外标法定量. 结果普通饮食组患者术后血浆中多种游离氨基酸水平降低,且术后第6天仍有4种氨基酸含量明显低于术前值(P<0.05);能全力组患者术后亦有部分血浆游离氨基酸含量降低,但术后第6天均恢复(P>0.05)或超过其术前值(P<0.05).术后同时间点能全力组患者多种血浆游离氨基酸水平高于普通饮食组患者(P<0.05). 结论心瓣膜置换术后患者血浆中多种游离氨基酸水平明显降低,术后早期能全力肠内营养支持有助于维持这些患者血浆游离氨基酸谱的平衡.

Effect of early postoperative enteral nutrition support on the levels of free amino acids in plasma for patients with cardiac valve replacement

Objective To investigate the effect of early postoperative enteral nutrition support on the balance of free amino acid spectrum in plasma for patients with cardiac valve replacement during perioperative period. Methods (Forty-seven) patients undergoing cardiac valve replacement were divided into two groups randomly, the routine diet group and the Nutrison Fibre group. The levels of free amino acids in plasma were measured with pre-column derivatization of high-performance liquid chromatography. Results During perioperative period most free amino acids in plasma decreased significantly in the routine diet group (P<0.05). Despite some free amino acids in plasma decreased significantly in the Nutrison Fibre group(P<0.05), all free amino acids in plasma returned to (P>05) or were higher than the preoperative levels in the postoperative sixth day (P<0.05). At the same postoperative points, most free amino acids in plasma in the Nutrison Fibre group were higher than that of the routine diet group (P<0.05). Conclusions The levels of free amino acids in plasma decrease significantly in patients with cardiac valve replacement after operation. Early postoperative Nutrison Fibre enteral nutrition support is helpful for keeping the balance of free amino acids in plasma for patients with cardiac valve replacement.