摘要
目的:探究经ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌(PCA)根治术患者术后炎性介质及免疫功能的影响。方法:将接受胰十二指肠切除术的80例PCA患者随机分为常规组(n=40)和ω-3组(n=40),常规组术后给予常规肠外营养治疗,ω-3组给予ω-3多不饱和脂肪酸强化的肠外营养治疗,均治疗14 d。比较两组术前、术后1 d、术后7 d、术后14 d血常规指标[白细胞(WBC)、淋巴细胞百分率(LYMPH%)、中性粒细胞在白细胞中所占百分比(NEUT%)、红细胞(RBC)]、营养指标[总蛋白(TP)、白蛋白(ALB)、前白蛋白(PALB)]、炎性介质[白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)]和免疫指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、成熟T淋巴细胞(CD3^(+))、诱导性T细胞(CD4^(+))]变化,并对比两组并发症情况、住院时间及住院费用。结果:术后,两组患者WBC、NEUT、RBC均呈先增加后下降趋势(均P<0.05),且ω-3组与常规组比较无统计学差异(P>0.05);两组患者LYMPH呈先降低后增加趋势(P<0.05),ω-3组与常规组比较无统计学差异(P>0.05)。术后,两组患者TP、ALB、PALB、IgA、IgG、CD3^(+)、CD4^(+)均呈先降低后增加趋势(均P<0.05),且ω-3组大于常规组(P<0.05);两组患者IL-6、IL-1、TNF-α均呈先降低后增加趋势(均P<0.05),且ω-3组小于常规组(P<0.05);两组并发症发生、总住院天数和术后住院天数比较无统计学差异(均P>0.05);ω-3组总住院费用显著高于常规组(P<0.05)。结论:经ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌患者术后效果理想,可有效改善营养水平,调节炎性介质和免疫功能,但花费较高。
Objective:To investigate the effects ofω-3(omega-3)polyunsaturated fatty acid-enhanced parenteral nutrition on postoperative inflammatory mediators and immune function in patients with radical resection of pancreatic cancer(PCA).Methods:A total of 80 patients with PCA who received pancreaticoduodenectomy were selected and randomly divided into conventional group(40 cases)andω-3 group(40 cases).The conventional group was given conventional parenteral nutrition therapy after surgery,and theω-3 group was givenω-3 polyunsaturated fatty acid-enhanced parenteral nutrition therapy,and both groups were treated for 14 days.Blood routine parameters[white blood cell(WBC),lymphocyte percentage(LYMPH%),neutrophil percentage in white blood cells(NEUT%),red blood cell(RBC)],nutritional parameters[total protein(TP),albumin(ALB),prealbumin(PALB)],inflammatory mediators[interleukin 6(IL-6),IL-1,tumor necrosis factor-α(TNF-α)]and immune indicators[immunoglobulin A(IgA),immunoglobulin G(IgG),mature T lymphocyte(CD3^(+)),inducible T cell(CD4^(+))]were compared between the two groups before surgery and at 1,7,14 days after surgery.The complications,hospital stay and hospitalization cost were compared between the two groups.Results:After surgery,the WBC,NEUT and RBC were first increased and then decreased in both groups(all P<0.05),and there were no significant differences betweenω-3 group and conventional group(all P>0.05).LYMPH in the two groups was decreased first and then increased(all P<0.05),but there was no significant difference betweenω-3 group and conventional group(all P>0.05).After surgery,the TP,ALB,PALB,IgA,IgG,CD3^(+)and CD4^(+)in the two groups were first reduced and then risen(all P<0.05),and their levels inω-3 group were higher than those in conventional group(all P<0.05).IL-6,IL-1 and TNF-αin both groups were first declined and then elevated(all P<0.05),and their levels inω-3 group were lower than those in conventional group(all P<0.05).There were no significant differences in the occurrence of complicatio
作者
许严
麦刚
XU Yan;MAI Gang(Southwest Medical University,Luzhou 646000,China)
出处
《陕西医学杂志》
CAS
2023年第7期862-866,888,共6页
Shaanxi Medical Journal
基金
四川省德阳市科技计划重点研发项目(2021SZZ053)。
关键词
Ω-3多不饱和脂肪酸
肠外营养
胰腺癌
炎性介质
免疫功能
并发症
ω-3 Polyunsaturated fatty acid
Parenteral nutrition
Pancreatic cancer
Inflammatory mediators
Immune function
Complications
