Hepatic dysfunction during hyperalimentation.
Hepatic dysfunction during hyperalimentation.
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营养过剩期间肝功能障碍。
DOI：
10.1001/archsurg.1978.01370160162028
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发表时间：
1978
影响因子：
--
通讯作者：
R. Sanders
中科院分区：
文献类型：
--
作者：
G. Sheldon;S. Petersen;R. Sanders
对26例静脉高营养(IVH)期间出现肝功能异常的患者的肝活检标本进行了研究。评价IVH的临床表现和持续时间与肝脏形态变化的关系。早期肝脏改变包括脂肪变性，随着IVH的继续发展为进行性肝内胆汁淤积。必需脂肪酸缺乏、氨基酸失衡、热量过多和某些氨基酸的毒性表现被认为是致病因素。继发于IVH的肝脏脂肪变性可以通过降低输液中的葡萄糖浓度或注射无葡萄糖氨基酸溶液来治疗。这种常见的IVH并发症的临床重要性在于很难将其与重症患者胆汁淤积的其他原因区分开来。
Liver biopsy specimens were studied in 26 patients in whom liver function abnormalities developed during intravenous hyperalimentation (IVH). The clinical manifestations and duration of IVH were evaluated in relation to the morphological changes seen in the liver. Early hepatic changes consisted of fatty metamorphosis, and progressive intrahepatic cholestasis developed as IVH was continued. Essential fatty acid deficiency, amino acid imbalance, caloric excess, and toxic manifestations of certain amino acids are postulated as causative factors. The hepatic steatosis secondary to IVH may be treated by lowering the dextrose concentration of the infusion or by administering dextrose-free amino acid solutions. The clinical importance of this common complication of IVH is the difficulty in distinguishing it from other causes of cholestasis in seriously ill patients.