全营养混合液稳定性的实验研究及临床应用

摘要

为探索全营养混合液(TNA)经周围静咏应用合理性及了解脂肪乳剂在TNA液中的稳定性,测定了肠外营养液中各营养成分和按临床应用不同营养液配比的pH、渗透压;另用透视电镜观察脂肪乳剂在TNA中的颗粒大小、形态变化.结果显示:pH除10%脂肪乳剂为7.38外,余均在5.16～6.67;渗透压除脂肪乳剂为等渗外,余均为高渗液.将所有营养成分按临床应用比例混合后,其pH为6.20～6.30,渗透压1 624.58～1 934.03 kPa.脂肪乳剂混合前平均颗粒直径为0.4μm,脂肪乳剂加入TNA24小时后,平均直径0.35μm,颗粒完整,但与5%氯化钙或50%葡萄糖混合24小时后,颗粒直径达0.9μm,颗粒形态异常.按一定程序配制混合营养液,临床应用1 000人次,未见不良反应.%A study on the pH and osmotic pressure of various preparations and the individual components of total parenteral nutrition fluid was conducted.In addition,the diameter and the surface loooking of the fat emulsion particles were observed.The results showed:pH was 5.16-6.67 for all nutrients except for fat emulsion which was 7.38;and osmotic pressure was hypertonic for all nutrient components except for fat emulsion which was isotonic.The pH of pediatric TNA was 6.20-6.30 and osmotic pressure was 1624.58～1934.03kPa.The average particle diameter was 0.4μm and reduced to 0.35μm when it was put in TNA for 24 hours,and the surface was smooth.When fat emulsion mixed with 5%CaCl2 or 50%dextrose for 24 hours,its diameter increased to 0.9μm and the surface of particles was deformed.The TNA being so mixed in certain order has been used over one thousand times in clinical practice,no side effect was found.