摘要
目的观察以橄榄油为基础脂肪乳的肠外营养对结直肠癌手术患者免疫功能、术后恢复的影响。方法按前瞻、随机、盲法、对照的原则,将80例结直肠癌腹部手术后重症患者按照随机数表法,随机分为对照组及研究组,两组均给予规范肠外营养治疗,研究组用橄榄油为基础的脂肪乳(克凌诺,Clin Oleic),对照组用普通的中长链脂肪乳,比较两组患者术后常见并发症的发生率、肛门排气时间、静脉营养时间、术后住院时间、C反应蛋白水平,探究克凌诺对结直肠癌患者手术后肠道功能恢复、免疫功能改善的影响,并探究其可能的机制。结果两组患者一般情况无统计学差异;两组并发症(咽喉疼痛、恶心呕吐、重新置胃肠减压管、切口感染、肺部感染、肠梗阻、吻合口漏)的发生率无统计学差异(χ2=4.512,P>0.05);研究组患者免疫功能改善明显,C反应蛋白在研究组下降(67.470±43.786)mg/L,下降程度显著高于对照组(t=4.290,P<0.001);研究组患者术后恢复加快,肛门排气时间、静脉营养时间、术后住院时间均短于对照组,差异有统计学意义(P<0.05)。结论橄榄油脂肪乳能明显改善结直肠癌手术患者免疫功能,促进患者术后胃肠道功能恢复,加快患者康复。
Objective To observe the effects of olive oil-based lipid emulsion in parenteral nutrition on the immune function and postoperative recovery of patients with colorectal cancer. Methods 80 cases of colorectal cancer were randomized into two groups after critical abdominal surgery. Parenteral nutrition with structure lipid emulsion was processed in both groups after surgery. Treatment group was given olive oil-based lipid emulsion （ClinOleic）. Control group was added medium and long chain fat emulsion. Effects on the incidence of postoperative complications, anal exhaust time, intravenous nutrition, length of hospital stay, and the levels of C-reaction protein （CRP） were compared. The effect of postoperative intestinal function recovery and immune function improvement were investigated and the possible mechanism was explored. Results There was no statistical difference between the two groups. The incidences on complications （sore throat, nausea and vomiting, reposition gastrointestinal decompression tube, incision infection, pulmonary infection, intestinal obstruction, anastomotic leakage） have no statistical differences （χ2=4.512, P〉4.512）. In the treatment group, the immunological function of the patients were signifcantly improved, and the C-reactive protein decreased by 67.470-43.786 significantly （t=4.290, P〈0.001）. The time of anal venting, intravenous nutrition and postoperative hospitalization of treatment group were all shorter than the control group （P〈0.05）. Conclusions Olive oil-based lipid emulsion can signifcantly improve the immune function and accelerate the postoperative recovery of colorectal cancer.
作者
钱俊
李德川
范永田
冯海洋
QIAN Jun;LI De-chuan;FAN Yong-tian;FENG Hai-yang(Department of Colorectal Surgery, Zhejiang Cancer Center, Hangzhou 310013, Zhejiang, China)
出处
《肿瘤代谢与营养电子杂志》
2018年第1期38-42,共5页
Electronic Journal of Metabolism and Nutrition of Cancer
关键词
橄榄油脂肪乳
结构脂肪乳
结直肠癌
结直肠手术
Olive oil-based lipid emulsion
Structure lipid emulsion
Colorectal cancer
Colorectal surgery
