ω-3多不饱和脂肪酸联合清胰汤对原发性肝癌患者术后炎性反应和预后的影响  

The effects of ω-3 polyunsaturated fatty acid combined with Chinese medicine Qing Yi Tang on inflammatony reaction and clinical prognosis of post-operational patients hepatocellular carcinoma

作　　者：王代宏[1] 王芳元[1] 刘志苏[2] 

机构地区：[1]华中科技大学同济咸宁医院、咸宁市中心医院普外科,湖北咸宁437100 [2]武汉大学中南医院普外科

出　　处：《腹部外科》2013年第6期414-417,共4页Journal of Abdominal Surgery

基　　金：湖北省自然科学基金项目（No.2012FFC116）

摘　　要：目的 探讨ω-3多不饱和脂肪酸联合清胰汤对原发性肝癌患者术后炎性反应和预后的影响.方法 2011年4月至2013年1月,按拟定的纳入和剔出标准对行肝部分切除手术的42例肝癌患者随机分为对照组和研究组.两组患者术后连续接受低氮、低热量的全肠外营养支持治疗5 d,研究组患者加用ω-3多不饱和脂肪酸和清胰汤.检测两组患者术前和术后第2、7天肝功能、凝血功能、白细胞计数、中性粒细胞比率及C反应蛋白指标的变化,同时记录患者术后全身性炎症反应综合征（SIRS）发生情况、感染性并发症的发生率及住院时间.结果 研究组患者术后第2天血清前白蛋白（183.92±32.71）mg/L,白细胞计数（11.05±2.27）×109/L,术后第7天血清白蛋白（37.82±6.05）g/L、C反应蛋白（22.29±15.01）mg/L及天门冬氨酸转氨酶（30.31±11.62）U/L均明显优于对照组（P〈0.05）,其余指标差异均无统计学意义（P〉0.05）.研究组患者术后SIRS发生率23.8%和平均住院时间（9.25±2.02 d）明显低于对照组（P〈0.05）,两组患者其他术后感染性并发症差异无统计学意义 （P〉0.05）.结论 ω-3多不饱和脂肪酸联合清胰汤能减轻肝癌患者术后炎性反应,促进肠功能恢复和术后康复,缩短患者的住院时间.Objective To explore the effects of co-3 polyunsaturated fatty acids combined with Chinese medicine Qing Yi Tang on inflammatory reaction and clinical prognosis of post-operational pa- tients with hepatocellular carcinoma. Methods 42 cases with hepatocellular carcinoma were randomly divided into control group（n = 21） and study group（n = 21）. The two group patients were treated with hypocaloric parenteral nutrition, while the study group was received at3 polyunsaturated fatty acids combined with Chinese medicine Qing Yi Tang additionally. The total parenteral nutrition was trans- fused from the first day to the fifth day after operation. Liver function, blood coagulation function, white blood cell counts and levels of serum C-reactive protein（CRP） were detected on the day before the operation, the second and seventh day after operation. The incidence of systemic inflammatory re- sponse syndrome（SIRS）, complication, hospital stay and total costs in hospital were measured after operation. Results Compared to the control group on second day after operation, the serum levels pre- albumin in the study group was significantly higher, while white blood cell counts were significantly lower. The serum levels total albumin, aspartate aminotmnsferase and CRP in the study group were significantly better than those in the control group on seventh day after operation. Those other indica- tions were not significantly different between two groups（p〈0.05）. The incidence of SIRS and hospi- tal days in the study group was significantly lower than that in control group （P〈0. 05）. The incidence of complication and total costs were not significantly different between two groups（P〈0. 05）. Conclu- sion ω-3 polyunsaturated fatty acids combined with Chinese medicine Qing Yi Tang can restrain in-flammatory reaction of post-operational patients with hepatocellular carcinoma, and protect gut barrier function by alleviating the damage of intestinal mucosa. Receiving the help of ω-3 polyunsaturated fatty acid

关 键 词：肝癌 Ω-3多不饱和脂肪酸 清胰汤 炎性反应 

分 类 号：R442.8[医药卫生—诊断学]