肝癌切除术后病人ω-3脂肪乳的应用研究

Clinical study of ω-3 fatty acids in patients after resection operation of liver cancer

目的:研究肝癌病人接受肝切除术后使用ω-3脂肪乳对术后恢复的影响。方法:选择接受手术治疗的肝癌病人60例,随机分为两组,术后等氮、等热量PN支持。研究组病人使用中长链脂肪乳联合ω-3脂肪乳;对照组病人单纯使用中长链脂肪乳。分别于术后第1和第5天清晨抽取静脉血,检测肝功能、凝血功能、免疫球蛋白、淋巴细胞亚群等。同时记录病人全身炎症反应综合征(SIRS)发生率、感染性并发症发生率、术后住院时间和住院费用等。结果:研究组病人术后ALT、AST、总胆红素(TBIL)、ALB、PA等恢复优于对照组;凝血酶原时间(PT)、凝血酶原时间活动度(PTa)两组无显著性差异;研究组病人IgA、IgG、IgM、CD3、CD4/CD8等优于对照组(P<0.05);两组病人感染性并发症发生率、SIRS发生率、肝功能不全发生率均无显著性差异。结论:ω-3脂肪乳有助于改善肝癌病人肝切除术后免疫功能和肝功能。

Objective： To investigate the therapeutic effect of ω-3 fatty acids in patients after surgical operation of liver cancer. Methods ： sixty patients after surgical operation of liver cancer were randomly assigned to control and study groups. Both group received treatment of parenteral nutrition with equal ni- trogen and calories. The patients in control group received soybean oil, and those in study group received ω- 3 fish oil combind soybean oil. Liver function, blood coagulation function, immune globulin and lym- phocyte subgroup were measured on the first and fifth day postoperatively. Incidence of SIRS, inflamma- tory complications and in hospital time and cost of hospitalization were recorded. Results： ALT, AST, TBIL, PT ALB were significantly improveed in the study group as compared with control group. The im- mune globulin and lymphocyte subgroup were increased in the study group. Incidence of SIRS, inflamma- tory complications and hepatic dysfuntion were not significantly different between the two groups. Con- clusion ： TPN supplemented with ω-3 fatty acids can improve immune state and liver function of patients after resection operation of liver cancer.