ω-3脂肪酸肠外营养治疗重症肿瘤患者的临床研究  

Clinical study of parenteral nutrition with ω-3 fatty acids in critically ill cancer patients

作　　者：谢显龙[1] 王琤 黎阳[1] 黄英明[1] 老启芳[1] 何伊里[1] 卜昆鹏[3] 

机构地区：[1]广西医科大学附属肿瘤医院重症医学科,南宁市530021 [2]广西医科大学附属肿瘤医院营养科,南宁市530021 [3]广西医科大学附属肿瘤医院综合内科,南宁市530021

出　　处：《实用医学杂志》2017年第22期3745-3748,共4页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题项目(编号:Z2015591)

摘　　要：目的研究ω-3脂肪酸肠外营养对重症肿瘤患者营养、炎症反应、免疫及预后的影响。方法将60例危重肿瘤患者随机分为研究组和对照组,每组患者30例。两组患者均使用等氮及等热卡的肠内营养和肠外营养。研究组在常规营养的基础上添加ω-3脂肪酸肠外营养,观察两组患者每周的营养状况指标、炎性反应指标、免疫功能指标、预后指标(ICU死亡率、ICU住院时间、感染并发症)。结果研究组患者的营养、炎性反应和免疫指标较对照组改善。研究组的ICU住院时间较对照组短。与对照组的ICU病死率和感染并发症发生率相比,研究组的ICU病死率和感染并发症发生率较低,但差异不明显(P死亡率=0.13,P感染率=0.165)。结论ω-3脂肪酸肠外营养治疗重症肿瘤患者能提高患者的营养状态和免疫功能,降低患者机体炎症反应,缩短患者的住院时间,而不会显著改善ICU死亡率和减少感染并发症的发生率。Objective To investigate the effects of parenteral nutrition with ω-3 fatty acids on nutrition, inflammatory response, immunity and prognosis in critically ill cancer patients. Methods 60 critically ill cancer patients were randomly divided into study group and the control group, 30 cases each. All Patients were given isonitrogen and isocalorie enteral and parenteral nutrition for 2 weeks, which added ω-3 fatty acids in the study group by parenteral nutrition. The indicators of nutrition, inflammation, immune function were detected weekly, prognostic indicators （mortality, intensive care unit [ ICU ] length of stay, infectious complications ） were compared. Results The indicators of nutrition, inflammatory reaction and immune function of study group were significantly improved than control group, and length of stay in ICU of study group was shorter than control group. There were less mortality and morbidity of infection complications in the study group compared with control group, but difference were not significant （P = 0.13 and P= 0.165 ）. Conclusion ω-3 fatty acids supplementation of parenteral nutrition in critically ill cancer patients can improve nutritional status and immune function, reduce inflammatory response, shorten ICU length of stay, but not significantly improve ICU mortality and reduce infectious complications.

关 键 词：Ω-3脂肪酸 肠外营养 重症 肿瘤患者 

分 类 号：R459.3[医药卫生—治疗学] R730.5[医药卫生—临床医学]