ω-3多不饱和脂肪酸对腹腔镜结直肠癌术后迷走神经和肠功能恢复的影响  

Effect ofω-3 polyunsaturated fatty acids on recovery of autonomic nervous system and intestinal function after laparoscopic colorectal cancer surgery

作　　者：王刚 徐鹏演 赵旭安 王海锋 葛苗苗 潘华峰 江志伟 WANG Gang;XU Pengyan;ZHAO Xu'an;WANG Haifeng;GE Miaomiao;PAN Huafeng;JIANG Zhiwei(Department of General Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院普通外科,江苏南京210029

出　　处：《山东大学学报(医学版)》2025年第2期36-42,共7页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81500417)。

摘　　要：目的在心率变异性监测设备、连续肠鸣音听诊记录仪辅助下,观察ω-3多不饱和脂肪酸对腹腔镜结直肠癌术后迷走神经和肠功能恢复的影响。方法选取2022年2月—2024年6月在江苏省中医院行腹腔镜结直肠癌根治术患者126例,按照随机数字分配法将其分为观察组和对照组,每组63例,观察组术后第1天开始口服含ω-3多不饱和脂肪酸肠内营养制剂瑞能;对照组术后第1天开始后口服常规的肠内营养制剂能全力。观察肠功能恢复指标(术后肠鸣音恢复时间、术后首次排气时间、术后住院时间),反映自主神经功能的心率变异度指标(SDNN、pNN50、LF、HF、LF/HF),应激炎症指标(CRP、IL-1β、IL-2、IL-6、TNF-α、IFN-γ),术后并发症发生情况。结果观察组肠鸣音恢复时间、首次排气时间提前于对照组,差异有统计学意义(P<0.001);观察组术后第1天心率变异性指标pNN50高于对照组(P=0.031),第3天心率变异性指标SDNN、pNN50、HF均高于对照组(P=0.006,P=0.012,P=0.031);观察组术后第3天应激炎症指标CRP、IL-1β、IL-6水平低于对照组(P=0.032,P=0.035,P=0.001);两组术后并发症发生率差异无统计学意义(P=0.767)。结论ω-3多不饱和脂肪酸有保护腹腔镜结直肠癌术后患者迷走神经的功能,减轻全身炎症反应,促进肠功能康复。Objective To assess the effects ofω-3 polyunsaturated fatty acids on the recovery of autonomic nervous system and intestinal function after laparoscopic colorectal cancer surgery with the assistance of heart rate variability monitoring devices and continuous bowel sound auscultation recorders.Methods A total of 126 patients who underwent laparoscopic radical surgery for colorectal cancer at Jiangsu Province Hospital of Chinese Medicine from February 2022 to June 2024 were selected and randomly divided into an observation group and a control group,with 63 cases in each group.The observation group started oral administration of an enteral nutrition preparation containingω-3 polyunsaturated fatty acids(Supportan)on the first postoperative day.The control group initiated oral administration of a conventional enteral nutrition preparation(Nutison Fibre)on the first postoperative day.The study observed indicators of intestinal function recovery(time to bowel sound recovery,time to first flatus,length of postoperative hospital stay),heart rate variability indices reflecting autonomic nervous system function(SDNN,pNN50,LF,HF,LF/HF),stress-inflammatory markers(CRP,IL-1β,IL-2,IL-6,TNF-α,IFN-γ),and the occurrence of postoperative complications.Results The observation group had earlier recovery times for bowel sounds,first flatus,and first oral intake compared to the control group,with statistically significant differences(P<0.001).On the first postoperative day,the heart rate variability index pNN50 was higher in the observation group than that in the control group(P=0.031),and on the third day,the heart rate variability indices SDNN,pNN50,and HF were all significantly higher in the observation group than those in the control group(P=0.006,P=0.012,P=0.031).On the third postoperative day,the levels of stress-inflammatory markers CRP,IL-1βand IL-6 were lower in the observation group than those in the control group(P=0.032,P=0.035,P=0.001).There were no statistically significant differences in complication rate after sur

关 键 词：腹腔镜结直肠癌根治术 Ω-3多不饱和脂肪酸 胃肠道功能 迷走神经 心率变异性监测 连续肠鸣音听诊记录 

分 类 号：R459.3[医药卫生—治疗学] R656.9[医药卫生—临床医学] R657.1