摘要
目的探究ω-3鱼油脂肪乳在胃癌根治切除术后全胃肠外营养(TPN)中的应用效果。方法行根治切除术的胃癌患者分为对照组和试验组。对照组患者术后应用TPN,能量主要为葡萄糖和常规脂肪乳,每日热卡供给为100~125kJ·kg^(-1),深静脉置管滴注10~12h;试验组患者在对照组治疗的基础上,添加ω-3鱼油脂肪乳100mL,每日热卡供给及输注条件同对照组,2组均治疗7d。比较2组患者临床疗效,患者营养状况(总蛋白、转铁蛋白、白蛋白和氮平衡)、胃肠功能恢复情况、免疫功能[CD4+/CD8+和自然杀伤(NK)细胞]、腹腔引流液炎症因子[白细胞介素-6(IL-6)、IL-12p70、肿瘤坏死因子-α(TNF-α)]水平,并进行安全性评价。结果试验组和对照组分别纳入40和42例。治疗后,试验组和对照组的总有效率分别为90.00%(36例/40例)和71.43%(30例/42例),在统计学上差异有统计学意义(P<0.05)。2组患者总蛋白、转铁蛋白和白蛋白在术后3d均降低,但在术后7d升高,氮平衡在术后升高;但2组各时间段总蛋白、转铁蛋白、白蛋白和氮平衡的比较,在统计学上差异均无统计学意义(均P>0.05)。试验组与对照组首次排气时间分别为(55.72±9.75)和(61.52±10.43)h,试验组与对照组术后7d外周血CD4+/CD8+分别为1.50±0.38和1.29±0.30,NK细胞比例分别为(19.64±3.04)%和(17.24±2.96)%,引流液中IL-6水平分别为(18.77±4.69)和(32.36±5.18)pg·mL^(-1),IL-12p70分别为(6.14±1.86)和(8.93±2.17)pg·mL^(-1),TNF-α分别为(25.62±4.95)和(30.75±4.88)pg·mL^(-1),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。治疗期间,试验组的药物不良反应主要有呕吐、恶心、持续腹胀,对照组的药物不良反应主要有呕吐、恶心、持续腹胀。试验组和对照组的总药物不良反应发生率分别为20.00%和26.19%,在统计学上差异无统计学意义(P>0.05)。结论ω-3鱼油脂肪乳可提升胃癌患者术后免疫�
Objective To explore the application effect ofω-3 fish oil fat emulsion in total parenteral nutrition(TPN)after radical resection of gastric cancer.Methods Patients with gastric cancer undergoing radical resection in the hospital were divided into control group and treatment group.The patients in the control group were treated with TPN after operation,and the energy was mainly glucose and conventional fat emulsion.The daily calorie supply was 100-125 kJ·kg^(-1),and the deep venous catheter was dripped for 10-12 h.On the basis of the control group,the patients in the treatment group were added withω-3 fish oil fat emulsion 100 mL,and the daily calorie supply and infusion conditions were the same as those in the control group.Both groups were treated for 7 days.All patients were treated for 7 d.The nutritional status(total protein,transferrin,albumin,nitrogen balance),gastrointestinal function recovery,immune function[CD4^(+)/CD8^(+),natural killer(NK)cells],inflammatory factors[interleukin-6(IL-6),IL-12p70,tumor necrosis factor-α(TNF-α)]in abdominal drainage fluid and the safety was evaluated.Results There were 40 cases in treatment group and 42 cases in control group,respectively.After treatment,total response rates in treatment group and control group were 90.00%(36 cases/40 cases)and71.43%(30 cases/42 cases),and the difference was statistically significant(P<0.05).In the two groups,total protein,transferrin and albumin decreased at 3 d after surgery,but they all increased at 7 d after surgery,and nitrogen balance increased after surgery.There was no significant difference in total protein,transferrin,albumin or nitrogen balance between the two groups at different time periods(all P>0.05).The first exhaust time in treatment group and control group were(55.72±9.75)and(61.52±10.43)h.At 7 d after surgery,proportions of peripheral blood CD4+/CD8+levels in treatment group and control group were 1.50±0.38 and 1.29±0.30;proportions of NK cells were(19.64±3.04)%and(17.24±2.96)%;IL-6 levels in drainage fluid w
作者
徐雁
余晓婷
尹帅
XU Yan;YU Xiao-ting;YIN Shuai(Department of Critical Care Medicine,Hangzhou Cancer Hospital,Hangzhou 310002,Zhejiang Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2024年第18期2690-2694,共5页
The Chinese Journal of Clinical Pharmacology
关键词
Ω-3鱼油脂肪乳
胃癌
全胃肠外营养
免疫功能
炎症反应
腹腔引流液
ω-3 fish oil fat emulsion
gastric cancer
total parenteral nutrition
immune function
inflammatory response
abdominal drainage fluid
