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创伤病人常有高糖血症,此时输入高热量葡萄糖可增加CO_2产生和O_2消耗,导致儿茶酚胺分泌及肝功能异常。甘油是甘油三酯(TG)的水解产物,可通过三羧酸循环提供4.32Kcal/g的能量,在细胞内转运时不需要胰岛素的参与,还有节氮效应。作者以甘油代替葡萄糖作为TPN的主要能源用于危重病人,验证其减轻高糖血症、减少胰岛素用量及蛋白质分解的作用。方法:将22例多发伤病人随机分成两组,分别以葡萄糖和甘油作为碳水化合物来源,实验前一天输注5%葡萄糖液,第1～3天根据每日测定的静息能量消耗(REE)的1.3倍给予热量,氨基酸量为1.5g/Kg/日,脂肪量为100g/日,其余热量分别以葡萄糖和甘油供给。实验前及第1、3天取血测尿素氮(BUN)、肌酐(Cr)、葡萄糖、电解质、血气分析(ABG)、全血细胞计数、甘油、游离脂肪酸(FFA)、TG、胰岛素、白蛋白、
Traumatic patients often have hyperglycemia, then enter the high-calorie glucose can increase CO 2 production and O 2 consumption, leading to catecholamine secretion and liver dysfunction. Glycerol, a hydrolysates of triglycerides (TG), provides 4.32 Kcal / g of energy through the tricarboxylic acid cycle, does not require insulin for intracellular transport, and has a nitrogen-saving effect. The author replaces glucose with glycerol as the main energy source for TPN in critically ill patients to verify its role in reducing hyperglycemia, reducing insulin dosage and protein breakdown. Methods: Twenty-two patients with multiple trauma were randomly divided into two groups. Glucose and glycerol were used as the carbohydrate source respectively. Five days before the experiment, 5% dextrose solution was infused. The resting energy expenditure (REE ) 1.3 times the amount of calories, the amount of amino acids 1.5g / Kg / day, the amount of fat 100g / day, the remaining calories were fed with glucose and glycerol. BUN, creatinine, glucose, electrolytes, blood gas analysis (ABG), whole blood count, glycerol, free fatty acid (FFA), TG, insulin, albumin ,