ω-3多不饱和脂肪酸在老年胃癌病人术后肠外营养中的应用

目的: 研究在老年病人胃癌根治术后肠外营养(PN)中应用ω-3多不饱和脂肪酸(ω-3 PUFA)的作用. 方法: 将40例老年胃癌切除术后病人随机分为试验组和对照组,每组20例.对照组病人按低氮、低热量原则给予PN治疗,试验组加用ω-3 PUFA.比较两组病人营养指标、免疫指标、肝功能变化、炎性反应指标和并发症的发生率等. 结果: 试验组病人并发症的发生率为5%,对照组为20%,差异有显著性意义(P<0.05).术后经5 d的治疗,试验组病人PA水平、体液免疫和细胞免疫指标、IgA、IgG含量和CD4细胞均显著高于对照组(P<0.05,P<0.01).两组病人术后第1天IL-6、TNF-α和CRP水平均升高.第5天后,试验组IL-6、TNF-α和CRP显著低于对照组(P<0.05).对照组病人肝功指标明显升高,与试验组相比有显著性差异(P<0.05). 结论: ω-3 PUFA可通过阻断过度炎性反应、调节病人免疫功能和保护器官功能等作用,有利于老年胃癌病人术后的康复.

The effect of omega-3 polyunsaturated fatty acids on elder patients after gastric cancer operation

Objective: To investigate the clinical effect of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on elder patients after gastric cancer radical operation. Methods: Forty patients were randomly divided into experimental group (EG) and control group(CG). The patients of CG were treated with hypocaloric and lower nitrogen parenteral nutrition, and those in EG received ω-3 PUFA additionally. The nutrition index, immune function, liver function, inflammatory reaction and complications were compared. Results: The rate of complications significantly decreased in the EG (20% vs 5% , χ~2 = 3. 958, P < 0. 05). There were no significant differences in albumn and hemoglobin between the two groups (P > 0. 05). The level of prealbumin was significantly increased in the EG. The humoral immunity and cellular immunity were higher in the EG than those in the CG. IL-6, TNF-α and CRP levels on postoperative d5 were significantly depressed in the EG. Conclusion: Postoperative supplementation of ω-3 PUFA may have a favorable effect on the outcomes in elder gastric cancer patients.