二维超声测定全肠外营养患者胆囊排空功能的临床研究

袁霞萍　康春松　李杰　杨永生

　　摘要：目的：应用二维超声技术评价全肠外营养(TPN)患者静脉滴注氨基酸(IVAA)对胆囊的收缩作用。方法：30例TPN患者分3组，A组静脉滴注生理盐水为对照组，B、C两组IVAA。A、B两组采用二维超声测定胆囊排空分数(EF)并与同位素肝胆动态显像(C组)作对比。结果：B组IVAA后EF值明显高于A组(P<0.001)，而B、C两组的EF值无显著差异(P<0.05)，均在IVAA后40min最大值。结论：TPN患者IVAA可明显促进胆囊排空，是一种胃肠外的预防和治疗TPN淤胆和胆石形成的有效方法，安全价廉，具有重要临床价值。
　　关键词：全肠外营养；胆囊排空；二维超声
　　中图分类号：R445.1　　文献标识码：A
文章编号：1006－8716(2000)02－0089－03

The clinic study of the gallbladder emptying function with
total parenteral nutrition patients by dimensional ultrasonigraphy

YUAN Xia-ping，KANG Chun-song，LI Jie
(The First Hospital of Shanxi Medical University， Taiyuan 030001， China)

　　Abstract：Objective：Gallbladder empthing function in 30 patients with total parenteral nutrition after intravenous aminoacids (IVAA) infusion was measured by 2-dimensional ultrasonography and radionuclide cholescintigraphy. The purpose of this study was to evaluate the effects of IVAA on gallbladder contraction.Methods：Total cases were divided into three groups，Group A as control one was infused normal saline，Group B and C IVAA.Gallbladder Emptying Fraction (EF) in Gruop A and B was detected by real-time ultrasonography and compared to radionuclide cholescintigraphy (Group C).Results：The EF values in Group B after IVAA were significantly higher than those in Group A(P<0.001).There was no significant difference between Group B and C，and the peak EF value was appeared at 40 minetes after IVAA.Gonclution：IVAA can obviously promote gallbladder emptying， and was a kind of effective、 safety method of parenteral prevention and treatment to cholestasis and gallstone formation in TPN patients.
　　Key words：total parenteral nutrition；gallbladder empthing；2-Dimensional ultrasonography

　　近20年来，全肠外营养(TPN)，已广泛应用于临床，为营养衰竭患者提供了良好的人工胃肠营养支持，但与之有关的肝胆并发症成为棘手的问题，引起广泛关注。我们应用实时超声对TPN患者静脉滴注氨基酸(IVAA)促进胆囊排空功能进行前瞻性研究，并与同位素肝胆动态显像对照报告如下：
1　资料与方法
1.1　一般资料　选择1996年12月～1998年9月的外科住院患者30例，行TPN7d以上，其中男14例，女16

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