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完全胃肠外营养(TPN)时伴有胃肠道分泌减少,胃酸和胰液排出量都降低,已为人们所熟知。涉及TPN对胆汁分泌影响的研究则不多。TPN和肝功能损害有关,致使血清转氨酶、硷性磷酸酶和胆红素增高,这种变化的病理生理则和脂肪肝浸润的组织学改变及胆汁郁积改变有关。近年来注意到胆囊炎发病率增加和TPN有关,TPN并发膨胀的胆囊,可以无症状,可在TPN治疗的病人手术中偶然被发现,亦可用B型超声波发现或临床上表现为无结石胆囊炎。公认的解释认为,这是由于胃肠道内缺乏食物,胆囊收缩素-促胰酶素的刺激减少,使胆囊排空能力降低,胆囊疾病发病率增加的缘故,此解
It is well-known that total parenteral nutrition (TPN) is associated with reduced gastrointestinal secretion and decreased gastric acid and pancreatic fluid output. There are not many studies on the effects of TPN on bile secretion. TPN and liver damage, resulting in increased serum aminotransferase, alkaline phosphatase and bilirubin, the pathophysiology of this change is associated with histological changes of fatty liver infiltration and changes in cholestasis. In recent years, noted that the increased incidence of cholecystitis and TPN-related, TPN concomitant expansion of the gallbladder can be asymptomatic in the treatment of patients with TPN occasionally found in surgery can also be found with type B ultrasound or clinical manifestations of calculi cholecystitis . It is generally acknowledged that this is due to a lack of food in the GI tract, reduced stimulation of cholecystokinin-ghrelin, decreased ability to empty the gallbladder and increased incidence of gallbladder disease