摘要
目的观察重组人生长激素（rhGH）联合低热量营养对胃肠外科择期手术后患者的营养支持效果及对血糖的影响。方法将48例择期胃肠外科术后患者随机分为rhGH组和对照组，两组治疗和营养支持方案相同，rhGH组于术后第3-9天给予rhGH。在术前1d、术后3d和10d分别测定两组患者的体质量、血常规、肝肾功能和血浆蛋白指标，并每日检测氮平衡和血糖水平，观察并发症及不良反应，同时记录每日胰岛素用量。结果术后第10天，rhGH组累计氮平衡（13．21g）和血浆纤连蛋白水平[（104．77±19．94）mg/L]优于对照组[-6．88g和（93．03±16．03）mg/L]（P〈0．05）；术后第4天和第6-9天，rhGH组每日氮平衡均优于对照组（P〈0．05）；rhGH组治疗期间血糖水平升高[术后6d（7．68±2．15）mmol／L比（5．95±2．34）mmol／L，P〈0．05]，可为胰岛素有效控制，未发生严重并发症。结论rhGH联合低热量营养支持可以安全地促进蛋白合成和维持正氮平衡。改善营养状况和预后。
Objective To evaluate the impact of recombinant human growth hormone （rhGH） combined with hypocaloric nutrition on nitrogen balance and blood glucose in patients after gastrointestinal operation. Methods Forty-eight patients undergone abdominal operations were randomly divided into either subcutaneous rhGH （0.15 IU/kg） or placebo （menstruum） injection daily for 7 days postoperatively. These two groups had similar nutritional intakes. Body weight, blood cell count, liver and renal function, plasma albumin, prealbumin, transferrin and fibronectin were measured at day 1 before operation as baseline and day 3 and day 10 after operation by standard laboratory techniques. Nitrogen balance and blood glucose were measured from day 3 to day 9 after operation. Results At postoperative day 10, the cummulative nitrogen balance and the level of plasma fibroneetin were significantly higher in rhGH group [ 13.21 g, （104.77±19.94）mg/L] than those in placebo group [-6.88 g, （93.03±16.03）mg/L] （P〈0.05）. Furthermore, at day 4 and from day 6 to day 9 after operation, daily nitrogen balance was higher in rhGH group than that in control group （P〈0.05）. Mean blood glucose level was significantly higher in rhGH group from day 3 to day 6 after operation [（7.68±2.15） vs （5.95±2.34）mmol/L, P〈0.05]. But hyperglycemia could be controlled well by insulin treatment. Conclusion Growth hormone combined with hypocaloric nutrition is effective and safe in promoting positive nitrogen balance and protein synthesis in post-operative patients, which is also beneficial to the improvement of nutritional status and prognosis.
出处
《中华胃肠外科杂志》
CAS
2008年第1期50-53,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
重组人生长激素
营养支持
高血糖症
血糖
氮平衡
Recombinant human growth hormone
Nutritional support
Hyperglycemia
Blood glucose
Nitrogen balance
