ω-3鱼油脂肪乳注射液联合肠内营养在脓毒症患者中的应用价值  

ω-Application value of fish oil fat emulsion injection combined with enteral nutrition in patients with sepsis

作　　者：吴跃明[1] 徐俊龙[1] 楼天正[1] 邓勋涛 WU Yue-ming;XU Jun-long;LOU Tian-zheng(Department of ICU,Lishui People’s Hospital,Lishui,Zhejiang 323000 China)

机构地区：[1]浙江省丽水市人民医院ICU,浙江丽水323000

出　　处：《中国中西医结合外科杂志》2023年第3期354-357,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：浙江省基础公益项目资助(LGF20H150008)。

摘　　要：目的:探讨ω-3鱼油脂肪乳注射液联合肠内营养在脓毒症患者中的应用价值。方法:选取我院2018年3月—2021年2月收治的72例脓毒症患者为研究对象,采用投掷硬币法分为对照组(n=37)和观察组(n=35)。对照组根据中国脓毒症/脓毒性休克急诊治疗指南(2018)进行规范治疗,观察组在对照组基础上加用ω-3鱼油脂肪乳注射液。对比两组患者28 d死亡风险、APACHEⅡ评分、C反应蛋白(CRP)水平、入住重症监护室(ICU)时间是否存在差异。结果:对照组28 d内死亡10例(27.03%),观察组死亡7例(20.00%),两组28 d死亡率差异无统计学意义(χ^(2)=0.36,P=0.55);两组28 d死亡风险差异无统计学意义(HR=0.71,95%CI:0.27~1.82,P=0.47)。对照组和观察组患者平均死亡时间分别为(15.03±6.27)d和(15.64±4.81)d,差异无统计学意义(t=0.22,P=0.83)。治疗后,对照组和观察组患者APACHEⅡ评分出现下降趋势,而第6天[(14.21±2.56)vs(12.12±2.54)]分和第7天[(13.86±2.25)vs(11.67±2.32)]分,观察组低于对照组(P<0.05)。治疗后对照和观察组患者血清CRP水平呈下降趋势,从第3天开始[(69.88±11.21)vs(70.23±10.66)]mg/L,观察组血清CRP水平低于对照组(P<0.05)。观察组入住ICU时间为(15.22±4.03)d,短于对照组(16.87±4.22)d,差异有统计学意义(t=2.69,P<0.05)。结论:ω-3鱼油脂肪乳注射液联合肠内营养可降低患者血清CRP水平及APACHEⅡ评分,改善炎症状态,缩短入住ICU时间,但不能降低28 d死亡风险。Objective To explore ω-Application value of fish oil fat emulsion injection combined with enteral nutrition in patients with sepsis.Methods 72 patients with sepsis from March 2018 to February 2021 in our hospital were selected and divided into control group(n=37)and observation group(n=35)by coin tossing.The control group received standard treatment according to guidelines for the emergency management of sepsis/septic shock in China(2018),and the observation group was added on the basis of the control group ω-3 fish oil fat emulsion injection.The 28-day mortality risk,APACHE II score,CRP level and ICU stay time of the two groups were compared.Results Ten cases(27.03%)died within 28 days in the control group and 7 cases died(20.00%)in the observation group.There was no significant difference in 28 day mortality between the two groups(χ^(2)=0.36,P=0.55);There was no significant difference in 28 day mortality risk between the two groups by log rank test(HR=0.71,95%CI:0.27-1.8,P=0.47).The average time of death in the control group and the observation group was(15.03±6.27)days and(15.64±4.81)days,with no significant difference(t=0.22,P=0.83).After treatment,the APACHE II score of the two groups showed a downward trend.From the 6th day(14.21±2.56)vs(12.12±2.54)to 7th day(13.86±2.25)vs(11.67±2.32),APACHE II score of the two groups showed statistical difference(P<0.05).After treatment,the serum CRP score of the two groups showed a downward trend.From the third day(69.88±11.21)vs(70.23±10.66)mg/L,the serum CRP level of the two groups showed statistical difference(P<0.05).The average ICU stay time of patients in the observation group and the control group was(15.22±4.03)and(16.87±4.22)days.The observation group was shorter than the control group,and there was significant difference(t=1.69,P<0.05).Conclusion ω-3 fish oil fat emulsion injection combined with enteral nutrition can reduce the level of serum CRP and APACHE II score,improve the inflammatory state and shorten the stay time in ICU,but it cannot reduc

关 键 词：Ω-3鱼油脂肪乳 脓毒症 28天死亡率 C反应蛋白 

分 类 号：R573.9[医药卫生—消化系统] R631[医药卫生—内科学]