ω-3鱼油脂肪乳在腹腔镜胰十二指肠切除术后肠外营养支持治疗中的影响

Effect ofω-3 Fish Oil Fat Emulsion in the Parenteral Nutritional Support Treatment Following Laparoscopic Pancreaticoduodenectomy.

目的探讨ω-3鱼油脂肪乳在腹腔镜胰十二指肠切除术后肠外营养支持治疗的应用价值。方法采用回顾性队列研究方法。收集2017年1月至2020年12月内江市第二人民医院收治的61例行腹腔镜胰十二指肠切除术患者的临床资料,其中33例患者LPD术后肠外营养支持治疗添加ω-3鱼油脂肪乳100 ml,设为观察组;另28例患者LPD术后营养支持治疗添加普通脂肪乳,设为对照组。分析并比较两者患者围手术期临床相关资料:围手术期营养指标、围手术期炎症反应指标、围手术期免疫学检查指标、术后并发症情况。结果围手术期营养指标:比较两组患者术前及术后第1天、第3天、第5天的白蛋白、总蛋白、血红蛋白,差异均无统计学意义(P>0.05)。围手术期炎症指标:比较两组患者术前及术后第1天、第3天、第5天的白细胞计数、中性粒细胞百分比、降钙素原、白细胞介素6,差异有统计学意义(P<0.05)。围手术期免疫学指标:比较两组患者术前及术后第1天、第3天、第5天的IgA、IgG、IgM、CD4+、CD8+、CD4+/CD8+,差异有统计学意义(P<0.05)。术后并发症情况:观察组术后并发症的发生率24.2%(8/33),其中胰漏6例,肺部感染1例,切口感染1例。对照组术后并发症的发生率42.9%(12/28),其中胰漏7例,切口感染1例,腹腔感染3例,肺部感染1例,两组患者经过对症及支持等治疗均获得治愈。两组患者并发症发生率比较,差异有统计学意义(P<0.05)。结论ω-3鱼油脂肪乳在腹腔镜胰十二指肠切除术后肠外营养治疗中能减轻术后炎症反应,降低术后并发症的发生率。

Objective To explore the application value of omega-3 fish oil fat emulsion in the treatment of parenteral nutrition support after laparoscopic pancreaticoduodenectomy.Methods A retrospective cohort study method was used.Clinical data of 61 patients undergoing laparoscopic pancreaticoduodenectomy from January 2017 to December 2020 in Neijiang Second People,s Hospital were collected,33 patients were treated with 100ml omega-3 fish oil fat emulsion added to parenteral nutrition support after LPD and set as the observation group;the other 28 patients were treated with ordinary fat emulsion after LPD nutritional support treatment and set as the control group.Analyzing and comparing the perioperative clinical data of the two groups of the patients for:nutritional indicators in the perioperative period、inflammatory response indicators in the perioperative period、immunological examination indicators in the perioperative period、postoperative complications.Results Nutritional indicators in the perioperative period:the albumin,total protein,and hemoglobin of the two groups of patients before operation and on the first day,third day,and fifth day after operation were compared,and there was no statistically significant difference(P>0.05).Inflammatory response indicators in the perioperative period:the white blood cell count,neutrophil percentage,procalcitonin,and interleukin-6 of the two groups before surgery and on the first day,third day,and fifth day after surgery were compared and the differences had statistical significance(P<0.05).Immunological examination indicators in the perioperative period:the IgA,IgG,IgM,CD4+,CD8+,CD4+/CD8+of the two groups before operation and on the first day,third day,and fifth day after the operation were compared with statistically significant differences(P<0.05).Postoperative complications:The incidence of postoperative complications in the observation group was 24.2%(8/33),including 6 cases of pancreatic leakage,1 case of lung infection,and 1 case of incision infection.The incidence of postoperative complications in the control group was 42.9%(12/28),including 7 cases of pancreatic leakage,1 case of incision infection,3 cases of abdominal cavity infection,and 1 case of lung infection.Both groups of patients were cured after symptomatic and supportive treatment.Comparing the incidence of complications between the two groups of patients,the difference was statistically significant(P<0.05).Conclusionω-3 fish oil fat emulsion can reduce postoperative inflammation and the incidence of postoperative complications in parenteral nutrition therapy after laparoscopic pancreaticoduodenectomy.