【摘要】 目的　了解胃肠道手术后患者应用全肠外营养 (totalparenteralnutrition ,TPN)的实际临床价值。方法　将 2 36例接受胃肠道手术患者 (非重度营养不良 )随机分为TPN组 (术后给予氨基酸、脂肪乳剂、葡萄糖和电解质 )与对照组 (术后仅给予葡萄糖和电解质 )术后营养状况、空腹血糖、肝功能、并发症发生率及住院时间。结果　两组均无手术死亡。TPN组与对照组术后氮平衡及血浆蛋白变化无明显差异 ,术后 14天体重丢失分别为 (1.6 3± 2 .6 2 )kg和 (2 .75± 2 .33)kg(P <0 .0 1) ,术后 3天空腹血糖分别增高 (4.96± 2 .86 )mmol/L及 (2 .0 8± 2 .2 2 )mmol/L(P <0 .0 1) ,TPN组术后肝功能指标升高较对照更明显。两组术后并发症发生率分别为TPN组 11.0 2 % ,对照组 9.32 % (P >0 .0 5 ) ,住院时间分别为TPN(2 8± 12 )天 ,对照组 (2 6± 11)天 (P >0 .0 5 )。结论　对术前营养正常或轻中度营养不良患者 ,在接受胃肠道手术后常规应用TPN治疗没有实际临床价值更多还原

【Abstract】 Objective To investigate the clinical effects of total parenteral nutrition (TPN) in patients undergoing digestive tract surgical operation.Methods 236 patients(without severe malnutrition)undergoing digestive tract surgery were randomly divided into 2 groups.TPN group:patients receiving infusion of amino-acid,Lipid,glucose and electrolyte;control group:patients receiving infusion of glucose and electrolyte. The condition of nutrition,the free-food blood sugar(FBS), hepatic function,the rate of complication and the duration of hospitalization in post-operative were compared in both groups.Results There were no operative death in all.There were no statistical differences in nitrogen balance and serum total protein.By the end of the study the weight losed was (1.63±2.62)kg in TPN group and (2.75±2.33)kg in control group(P< 0.01) .The increased value of FBS in the TPN and control group was (4.96±2.86)mmol/L and (2.08± 2.22) mmol/L.The indication of hepatic function maintained stable in the control group,and increased signifficantly in the TPN group.The rate of post-operative complication was 11.02% in TPN group and 9.32% in control group,and the days in hospital were (28±12)days in TPN group and (26±11)days in control group.A comparison between the 2 groups showed that there were no obvious differences in rate of post-operative complications and days in hospital(P>0.05).Conclusions The study shows that TPN therapy or normal nourished or mildly malnurished patient undergoing digestive tract surgery is not clinical value.更多还原