臺灣博碩士論文加值系統

中 文 摘 要
本研究針對台大醫院一般外科胃癌手術患者，自 90年11月至 91年2月，依其全靜脈營養(total parenteral nutrient , TPN )投與之有無，分成二組，並於手術前、後各抽取空腹靜脈血液10 ml，用以分析一般生化指標(含血液特性、肝功能指標、腎功能指標)，進而分析鋅、銅等各元素的含量變化，最後進行統計分析，以瞭解TPN對一般外科胃癌手術患者之一般生化指標和血清鋅、銅元素濃度之影響。
結果發現，一般外科胃癌手術患者的血液特性大致呈現正常，祇發現血小板的平均值呈現手術後加TPN組明顯高於手術前及手術後未加TPN組(p<0.05 )。在白血球方面，嗜酸性白血球(eossinophil) 呈現手術後平均值明顯高於手術前(p<0.05)，單核球(monocyte)也呈現手術後加TPN組平均值明顯高於手術前(p<0.05)，但淋巴球(lymphocyte)則呈現手術後不加TPN組平均值明顯低於手術前(p<0.05)。在生化值方面，祇發現alanine transferase (ALT)呈現手術後加TPN組平均值明顯高於手術前(p<0.05)。至於血清鋅、銅元素濃度方面，血清鋅的平均濃度呈現手術後加TPN組略高於手術前，而血清銅則呈現平穩不變的現象。綜合上述，TPN對外科胃癌手術患者之癒後復原似乎具有少許協同作用。

Abstract
Attempts are made to study the effect of TPN (total parenteral nutrients) on the surgical patients who were suffered from gastric carcinoma. Twenty-one patients were operated during November 2001 to February 2002 and then devided into two groups supported with and without TPN supplement. After treatment, the blood of all patients were collected and analyzed the biological parameters and Zn2+, Cu2+ levels. It was found that the average level of serum platelet in the group with TPN supplement was significantly higher than that in the group without TPN supplement and themself before surgery (p<0.05). Eosinphil and monocyte levels in the group with TPN supplement were also significantly higher than those before surgery. But the lymphocyte levels in both groups with and without TPN supplement were lower than those before surgery. ALT (alanine transferase) activity in the group with TPN supplement was significantly higher than that before surgery as well. Zinc level in the group with TPN supplement was slightly increased, while copper level in both groups with and without TPN supplement were almost same. In conclusion, TPN for the surgical patients who were suffered from gastric carcinoma was somewhat benefit in coordination with restoration.

中文摘要------------------------------------------------- 1
英文摘要------------------------------------------------- 2
一、前言--------------------------------------------------3
二、研究背景----------------------------------------------4
1.血液常規檢查---------------------------------------- 4
2.血液生化值------------------------------------------ 8
3.鋅、銅元素------------------------------------------ 16
4.全靜脈營養------------------------------------------ 20
三、材料與方法------------------------------------------- 23
四、結果與討論------------------------------------------- 30
1.胃癌患者手術前後之血液特性變化-----------------------30
2.胃癌患者手術前後之血液白血球變化---------------------31
3.胃癌患者手術前後之血液生化值變化---------------------32
4.胃癌患者手術前後之血清中鋅、銅濃度變化-------------- 33
五、結論 ------------------------------------------------ 35
六、圖表------------------------------------------------- 36
七、參考文獻--------------------------------------------- 82
謝辭----------------------------------------------------- 86
附件----------------------------------------------------- 87

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謝博生，臨床數據―判讀與應用，醫學文摘出版社，台北市 (1976)。