术前给予ω-3鱼油脂肪酸降低恶性梗阻性黄疸患者术后胆道感染发生的效果  

Effects of preoperative administration of ω-3 fatty acids in fish on postoperative biliary tract infection in patients with malignant obstructive jaundice

作　　者：刘承利[1] 赵刚[1] 肖梅[1] 徐新保[1] 张辉[1] 孔亚林[1] 王成[1] LIU Cheng-li ZHAO Gang XIAO Mei et al(Department of Hepatobiliar Surgery, Air Force General Hospital of PIA （Beifing ,100142） China)

机构地区：[1]中国人民解放军空军总医院肝胆外科,北京100142

出　　处：《中西医结合肝病杂志》2017年第2期77-79,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：首都市民健康项目培育课题(No.Z131100006813010)

摘　　要：目的:探讨术前给予ω-3鱼油脂肪酸降低恶性梗阻性黄疸患者术后感染发生的效果。方法:采用前瞻性研究方法,选择2013年9月到2016年2月在我科住院的恶性梗阻性黄疸患者156例,根据入院顺序随机分为观察组与对照组各78例,两组患者均行PTCD^+胆道支架植入术治疗,观察组患者术前5d开始口服ω-3鱼油脂肪酸,对照组患者术前不用ω-3鱼油脂肪酸。检测两组患者术后1d、术后15dT细胞免疫功能变化,观察与记录术后胆道感染发生率及其肝功能指标。结果:观察组患者术后15d的CD4^+值明显高于术后1d(P<0.05),也明显高于对照组(P<0.05),CD8^+值在组内与组间对比差异都无显著性意义(P>0.05)。两组患者术后1d与术后15d的血清ALT和AST在组内与组间对比差异无显著性意义(P>0.05)。观察组患者术后15d的感染发生率为5.6%,对照组为25.0%,观察组患者术后感染发生率明显少于对照组(P<0.05)。观察组与对照组的死亡率分别为2.56%(2/78)和5.13%(4/78),差异无显著性意义(P>0.05)。结论:术前给予ω-3鱼油脂肪酸能改善胆道支架植入术后患者的细胞免疫功能,从而降低术后感染的发生率。Objective： To investigate the effects of preoperative administeration of ω-3 fatty acids in fish on postoperative biliary tract in- fection in patients with malignant obstructive jaundice. Methods： Using the prospe-ctive study method, 156 cases from September 2013 to February 2016 in our department for treatment of malignant obstructive jaundice patients were randomly divided into observation group and control group with 78 cases in each group according to the order of admission, two groups were given biliary stent implantation. The observa- tion group were given oral ω-3 fish oil fatty acids before 5 days, and the control group not given. De-tecting the changes of immune function of 15dT ceils in I D after operati-on, the postoperative infection incidence and the changes of the related index were observed and recorded. Results： The 15 d value of CD4^＋ in the observation group was significantly higher than that of postoperative 1D and control group （ P 〈 0.05 ） and there was no significant difference between the CD8^＋ group and the control group （P 〉 0.05） ; There was no signif-ieant difference be- tween the two groups in postoperative 1D and 15d abo-ut the serum ALT and AST （P 〉0.05 ）. The incidence of 15d infection in the observa- tion group was less than that Of the control group （5.6% vs 25.0%, P 〈0.05） ; The mortality rate of the observation group and the control group were 2.56% （2/78） and 5.13% （4/78）, respeetly, the difference was not statistically significant （P 〉 0.05 ）. Conclusion： preoper- ative administ-eration of ω-3 fatty acids in fish could improve the cellular immune func-tion of patients after biliary stent implantation, so , it could reduce the inci-denee of postoperative infection.

关 键 词：ω-3鱼油脂肪酸 恶性梗阻洼黄疸 胆道支架植入术 胆道感染 

分 类 号：R730.5[医药卫生—肿瘤]