鱼油脂肪乳剂对胃肠癌患者术后免疫功能及预后的影响  

Effect of fish oil fat emulsion on postoperative immune function and prognosis in patients with gastrointestinal cancer

作　　者：张玉亮[1] 戴洪山[1] 朱宏[1] ZHANG Yuliang;DAI Hongshan;ZHU Hong(Department of General Surgery,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省中医院普外科,江苏210029

出　　处：《现代医药卫生》2018年第23期3616-3619,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨鱼油脂肪乳对胃肠癌患者术后免疫功能及预后相关性的影响。方法选取2017年3月1日至2018年6月30日该科收治的择期行开放手术胃肠癌确诊患者69例作为研究对象,采用信封法随机分为研究组(36例)和对照组(33例)。2组患者均给予含中长链脂肪乳剂肠外营养(PN)治疗,研究组加用鱼油脂肪乳。分别于患者术前1 d,术后1、6 d检测血浆异常糖链糖蛋白(TAP)、外周血T淋巴细胞亚群(CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)比值)的变化;观察术后通气时间、排便时间、住院时间、术后感染发生率情况。结果2组患者术前1 d CD^(3+)、CD^(4+)、CD^(8+)T淋巴细胞,CD^(4+)/CD^(8+)比值与术后1 d比较,差异均无统计学意义(P>0.05)。2组术后1 d CD^(3+)、CD^(4+)T淋巴细胞,CD4^+/CD^(8+)比值明显低于术前1 d,差异均有统计学意义(P<0.05)。研究组术后6 d CD^(3+)、CD^(4+)T淋巴细胞、CD^(4+)/CD^(8+)比值明显高于对照组,差异均有统计学意义(P<0.05)。研究组术后6 d TAP表达水平明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者术后通气、排便、住院时间及术后感染发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论胃肠癌术后使用含有鱼油脂肪乳的PN治疗,有利于改善患者术后免疫功能,促进术后早期恢复,降低肿瘤指标、住院时间及并发症发生率,改善临床预后。Objective To explore the effect of fish oil on postoperative immune function and prognosis in the patients with gastrointestinal cancer.MethodsSixty-nine patients with gastrointestinal cancer undergoing elective open operation in the general surgery of the hospital from March 1,2017 to June 30,2018 were selected as the study subjects,and randomly divided into the research group（36 cases）control group（33 cases）and by adopting the envelope method.Both groups were given parenteral nutrition（PN）treatment with medium and long chain fat emulsion,and the research group was supplemented with fish oil fat milk.The changes of plasma abnormal carbohydrate chain glycoprotein（TAP）and peripheral blood T-lymphocyte subsets（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ratio）were detected on preoperative 1 d and postoperative 1,6 d respectively;the postoperative exhaust time,defecation time,length of hospitalization stay and incidence rate of postoperative infection were observed.Results The levels of CD3＋,CD4＋,CD8＋and CD4＋/CD8＋ratio in the two groups had no statistical difference between preoperative 1 d and postoperative 1 d（P〉0.05）.The levels of CD3＋,CD4＋and CD4＋/CD8＋ratio on postoperative 1 d in the two groups were significantly lower than those on preoperative 1 d,and the differences were statistically significant（P〈0.05）.The levels of CD3＋,CD4＋and CD4＋/CD8＋ratio on postoperative 6 d in the research group were higher than those in the control group,the differences were statistically significant（P〈0.05）.The TAP expression level on postoperative 6 d in the research group was significantly lower than that in the control group,and the differences were statistically significant（P〈0.05）.The postoperative exhaust time,defecation time,hospitalization time and incidence rate of postoperative infection in the research group were significantly lower than those in the control group,and the difference was statistically significant（P〈0.05）.Conclusion Using the parenteral nut

关 键 词：鱼油脂肪乳 胃肠癌 免疫功能 术后 

分 类 号：R735[医药卫生—肿瘤]