ω-3不饱和脂肪酸促进胃肠道恶性肿瘤患者术后康复的疗效研究

Effect of ω-3 Polyunsaturated Fatty Acid on Promoting The Postoperative Rehabilitation of Patients with Gastrointestinal Malignancies

目的研究ω-3不饱和脂肪酸促进胃肠道恶性肿瘤患者术后康复及减少术后并发症的作用。方法将华西医院胃肠外科2009年2月1日至6月1日收治的40例胃肠道恶性肿瘤患者按随机数字表法分为对照组和实验组各20例。术后2组连续行7d肠外营养支持治疗,实验组每天加用ω-3不饱和脂肪酸10g。术前、术后第2天及第8天早晨分别抽血检测患者肝、肾功能及机体免疫指标,并记录2组患者的术前及术后7d平均体温、术后肛门排气时间、术后住院时间及并发症发生情况。结果2组患者的一般情况具有可比性(P>0.05)。术后第2天,实验组总胆红素水平低于对照组,NK细胞及B细胞水平高于对照组,差异均有统计学意义(P<0.05);术后第8天,实验组谷丙转氨酶、谷草转氨酶及血尿素氮水平低于对照组,CD4+细胞及NK细胞水平高于对照组,差异亦有统计学意义(P<0.05)。实验组术后肛门排气时间及术后住院时间明显短于对照组,差异有统计学意义(P<0.05);2组间术后平均体温及术后并发症发生率相比较,差异均无统计学意义(P>0.05)。结论ω-3不饱和脂肪酸能够促进患者术后肝、肾功能和机体免疫功能恢复,促进术后肠道功能恢复及缩短术后住院时间,但是对术后并发症发生率无明显影响。

Objective To research the effect of ω-3 polyunsaturated fatty acid （PUFA） on promoting the postoperative rehabilitation of patients with gastrointestinal malignancies in order to decrease the incidence of postoperative complications and the days of postoperative hospital stay. Methods Forty patients with gastrointestinal malignancies in West China Hospital of Sichuan University from February 1st, 2009 to June 1st, 2009 were included and allocated to experimental group （20 cases） and control group （20 cases） randomly. Seven days parenteral nutrition was provided to them after operation. Compared with control group, ω-3 PUFA with a dose of 10 g was given to experimental group every day additionally. Blood samples were gained before operation, on the morning of day 2 and day 8 after operation respectively to measure hepatorenal and immune indexes. Temperature before and 1-7 d after operation, time of passing flatus to normal, postoperative complications and the postoperative hospital stay were recorded. Results There was no statistical difference in the baselines between experimental group and control group （P〉0.05）. The level of total bilirubin in experimental group was lower and the levels of NK cell and B cell in experimental group were higher than those in control group on day 2 after operation, there were statistical differences between them （P〈0.05）. The levels of ALT, AST and blood urea mitrogen in experimental group were lower and the levels of CD4^＋ cell and NK cell in experimental group were higher than those in control group on day 8 after operation, there were statistical differences between them, too （P〈0.05）. The time of passing flatus to normal and days of staying in hospital after operation in experimental group were shorter than those in control group, there were statistical differences between them （P〈0.05）. There was no statistical difference in postoperative average temperature and incidence of complications between two groups （P〉0.05）. Conclusions ω-3 PUFA has positive influence on the recovery of hepatorenal, immune and gastrointestinal function, and can shorten the days of postoperative hospital stay; but there is no effect on incidence of complications after operation.