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恶性梗阻性黄疸病人１３例，随机分为两组，围手术期给予不同脂肪乳剂（ＬＣＴ、ＭＣＴ／ＬＣＴ）的ＰＮ支持１０ｄ。结果显示：ＭＣＴ组术后及ＰＮ期间血ＣＨ、ＴＧ及ＬＤＬ逐渐下降，ＨＤＬ升高，Ｐ＜０．０５。两组血胆红素引流术后明显下降，ＩＢｉｌ在ＭＣＴ组下降更为明显，ＰＯＤ＋６ｄ已达正常，且与ＬＣＴ组比较Ｐ＜０．０１。两组血糖、肝酶、血浆蛋白与氮平衡变化趋势相同，手术前、后合并血糖升高，需补充适量胰岛素；引流后肝酶逐渐下降，ＰＡＢ、ＴＲＦ于ＰＮ期间逐渐升高，术后负氮平衡于ＰＯＤ＋４ｄ后得到纠正。结论：梗阻性黄疸引流术后双能源ＰＮ支持１０ｄ，含ＭＣＴ脂肪乳剂对血脂代谢及胆红素生成影响更小，并达到与ＬＣＴ同样的节氮效应。
Thirteen patients with malignant obstructive jaundice were randomly divided into two groups. Perioperative PN administration with different lipid emulsions (LCT, MCT / LCT) was performed for 10 days. The results showed that the blood CH, TG and LDL decreased gradually and the HDL increased in the MCT group (P <0.05). After bilirubin drainage, the levels of IBil decreased significantly in MCT group, POD + 6d had reached the normal level, and P <0.01 compared with LCT group. Blood glucose, liver enzymes, plasma protein and nitrogen balance trend of the same, before and after the merger of blood glucose, need to add the appropriate amount of insulin; liver enzymes gradually decreased after drainage, PAB, TRF during PN gradually increased, negative Nitrogen balance corrected after POD + 4d. CONCLUSION: The dual energy PN support after obstructive jaundice drainage for 10 days, with MCT fat emulsion has less effect on lipid metabolism and bilirubin production, and achieves the same nitrogen-saving effect as LCT.