【摘要】 目的 :探讨营养支持在急性肾功能衰竭 ( ARF)治疗中的作用。　方法 :对 12例 ARF病人在综合治疗的基础上给予全肠外营养 ( TPN )治疗 ,并对 ARF的二种临床类型 (单纯型 3例和表现为多脏器功能障碍综合症的 9例 )采用不同的 TPN方案 ,二组的热量分别为 10 4.6～ 12 5 .5 k J/ ( kg· d)和 12 5 .5～ 146 .4k J/ ( kg· d) ,非蛋白质热量 ( k J)∶氮量 ( g)分别为 6 0 0～ 10 0 0∶ 1和 2 0 0～ 30 0∶ 1。检测每天的血肌酐 ( Cr)、血尿素氮 ( BU N)及 TPN治疗前、治疗一周后的血清前白蛋白 ( PA)、转铁蛋白 ( TF)、白蛋白 ( Alb)浓度。　结果 :TPN治疗一周后的血 Cr、BU N均较治疗前明显下降 ( P<0 .0 1) ,并接近正常水平 ,血 PA、TF、Alb均较前有不同程度的升高。全部病人存活 ,无一例行血液透析。　结论 :有效的肠外营养支持可改善 ARF病人的肾功能和预后 ,充足的热量和必需氨基酸的供给是 ARF营养治疗的基础 ,但根据不同临床类型对氮源和热量作适当调整是必要的更多还原

【Abstract】 Objectives:To study the effect of nutritional support on acute renal failure(ARF). Methods:On the basis of common treatemnt,total parenteral nutrition(TPN) were given in 12 patients with ARF.The nonprotein calorie(kJ) and NPC∶nitrogen(g) were 104.6~125.5 kJ/(kg·d) and 600~1 000∶1 in simple ARF,and 125.5~146.4 kJ/(kg·d)and 200~300∶1 in MODS.Daily analysis of Cr and BUN, and determination of serum level of prealbumin(PA);transferrin(TF) and albumin(Alb) before and after one week treatment was completed. Results:After one week of TPN therapy,both the serum Cr and BUN decreased approximately to normal level(P<0.01).The serum concentrations of PA,TF and Alb increased obviously(P< 0.01 ,>0.05 and <0.01 respectively).All the patients were alive without hemodialysis. Conclusions:The TPN is effective in the treatment of ARF,but it is necessary to change the formula according to the clinical conditions,simple ARF or MODS.更多还原