胃肠外科肠外营养支持治疗中多种油脂肪乳的使用对于肝功能及相关炎性因子的影响分析
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摘要
目的探究胃肠外科肠外营养支持治疗中多种油脂肪乳的使用对肝功能及相关炎性因子的影响。方法选取2017年2月至2018年2月本院胃肠外科收治的接受肠外营养支持治疗患者96例,采用随机数字表法分为观察组与对照组,各48例。观察组配制多种油脂肪乳进行肠外营养支持治疗,对照组配制中长链脂肪乳进行肠外营养治疗,观察两组患者干预前后血清肝功能及炎性因子改变。结果两组患者干预前肝功能各指标差异无统计学意义,干预后血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、TBIL(总胆红素)及DBIL(直接胆红素)水平均明显下降(P<0.05),且观察组ALT、AST、TBIL、DBIL均显著低于对照组(P<0.05);两组患者干预前各炎症因子差异无统计学意义,干预后血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-1(IL-1)及白细胞介素-6(IL-6)水平均明显低于干预前(P<0.05),且观察组CRP、TNF-α、IL-1、IL-6均显著低于对照组(P<0.05)。结论采用多种油脂肪乳配制肠外营养液可显著促进胃肠外科患者肝功能恢复,有效抑制炎症反应,改善患者营养状况,具一定临床价值。
Objective To investigate the effect of various oil fat emulsions used in parenteral nutrition support therapy in gastrointestinal surgery department on liver function and related inflammatory factors. Methods A total of 96 patients undergoing parenteral nutrition support therapy in the hospital from February 2017 to February 2018 were divided into observation group and control group by random number table method, 48 cases in each group. The observation group was treated by parenteral nutrition support therapy with various oil fat emulsions while the control group was treated by parenteral nutrition therapy with long-chain fat emulsion. Changes of serum liver function and inflammatory factors in both groups before and after intervention were observed. Results There was no significant difference in liver function between the two groups before intervention. Levels of serum ALT(alanine aminotransferase), AST(aspartate aminotransferase), TBIL(total bilirubin) and DBIL(direct bilirubin) were decreased significantly after intervention(P<0.05), and the levels in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in inflammatory factors between the two groups before intervention. Levels of serum C-reactive protein(CRP),tumor necrosis factor α(TNF-α), interleukin-1(IL-1) and interleukin-6(IL-6) after intervention were significantly lower than those before intervention(P<0.05), and they were significantly lower in the observation group than in the control group(P<0.05). Conclusion The preparation of parenteral nutrition solution with various oil fat emulsions can significantly promote the recovery of liver function in patients in gastrointestinal surgery department, effectively inhibit inflammatory response, and improve the nutritional status of patients, with certain clinical value.
Objective To investigate the effect of various oil fat emulsions used in parenteral nutrition support therapy in gastrointestinal surgery department on liver function and related inflammatory factors. Methods A total of 96 patients undergoing parenteral nutrition support therapy in the hospital from February 2017 to February 2018 were divided into observation group and control group by random number table method, 48 cases in each group. The observation group was treated by parenteral nutrition support therapy with various oil fat emulsions while the control group was treated by parenteral nutrition therapy with long-chain fat emulsion. Changes of serum liver function and inflammatory factors in both groups before and after intervention were observed. Results There was no significant difference in liver function between the two groups before intervention. Levels of serum ALT(alanine aminotransferase), AST(aspartate aminotransferase), TBIL(total bilirubin) and DBIL(direct bilirubin) were decreased significantly after intervention(P<0.05), and the levels in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in inflammatory factors between the two groups before intervention. Levels of serum C-reactive protein(CRP),tumor necrosis factor α(TNF-α), interleukin-1(IL-1) and interleukin-6(IL-6) after intervention were significantly lower than those before intervention(P<0.05), and they were significantly lower in the observation group than in the control group(P<0.05). Conclusion The preparation of parenteral nutrition solution with various oil fat emulsions can significantly promote the recovery of liver function in patients in gastrointestinal surgery department, effectively inhibit inflammatory response, and improve the nutritional status of patients, with certain clinical value.
引文
[1]黄文辉,林龙,黎明.胃肠外科肠外营养支持治疗中应用多种油脂肪乳对肝功能及相关炎性因子的影响[J].疑难病杂志,2017,16(3):259-262.
[2]罗爱国,黎光强,潘禹辰,等.围手术期肠内与肠外营养对老年食管癌术后转归的影响[J].当代医学,2016,22(18):34-36.
[3]曾亚兰,绍勇,兰仲军.多种油脂肪乳(SMOF)干预对食管癌术后应激激素、炎性介质及免疫功能的影响[J].海南医学院学报,2017,23(22):3085-3088.
[4]周斌,魏尉,文旭,等.结构脂肪乳和中长链脂肪乳对年龄≥70岁胃癌患者全胃切除联合食管空肠Roux-en-Y吻合术后疗效的影响[J].中华消化外科杂志,2017,16(12):1204-1209.
[5]蔡建平,王亚东,张晓,等.结构脂肪乳与中/长链脂肪乳对胰十二指肠切除术后病人肝功能、蛋白质代谢、细胞免疫功能及临床不良反应的影响[J].临床外科杂志,2017,25(10):781-784.
[6]吴青青.含鱼油脂肪乳剂在儿童肠外营养相关性肝病的临床应用进展[J].肠外与肠内营养,2016,23(3):185-188.
[7]任会娜,黄文祥.肠外营养相关性肝病的研究进展[J].中华肝脏病杂志,2017,25(7):557-560.
[8]庹敏,张云,周勇,等.胃癌根治术后早期行肠内、肠外营养支持对胃癌患者免疫及胃肠功能恢复的影响[J].当代医学,2017,23(30):74-76.
[9]魏来,赵春景.临床药师参与肠外营养相关性肝损害患者治疗的药学监护[J].中国药房,2017,28(17):2429-2432.
[10]林海鹏,卢晓明,管日戬,等.ω-3鱼油脂肪乳对老年胃癌患者术后恢复的影响[J].临床外科杂志,2016,24(12):907-909.
[2]罗爱国,黎光强,潘禹辰,等.围手术期肠内与肠外营养对老年食管癌术后转归的影响[J].当代医学,2016,22(18):34-36.
[3]曾亚兰,绍勇,兰仲军.多种油脂肪乳(SMOF)干预对食管癌术后应激激素、炎性介质及免疫功能的影响[J].海南医学院学报,2017,23(22):3085-3088.
[4]周斌,魏尉,文旭,等.结构脂肪乳和中长链脂肪乳对年龄≥70岁胃癌患者全胃切除联合食管空肠Roux-en-Y吻合术后疗效的影响[J].中华消化外科杂志,2017,16(12):1204-1209.
[5]蔡建平,王亚东,张晓,等.结构脂肪乳与中/长链脂肪乳对胰十二指肠切除术后病人肝功能、蛋白质代谢、细胞免疫功能及临床不良反应的影响[J].临床外科杂志,2017,25(10):781-784.
[6]吴青青.含鱼油脂肪乳剂在儿童肠外营养相关性肝病的临床应用进展[J].肠外与肠内营养,2016,23(3):185-188.
[7]任会娜,黄文祥.肠外营养相关性肝病的研究进展[J].中华肝脏病杂志,2017,25(7):557-560.
[8]庹敏,张云,周勇,等.胃癌根治术后早期行肠内、肠外营养支持对胃癌患者免疫及胃肠功能恢复的影响[J].当代医学,2017,23(30):74-76.
[9]魏来,赵春景.临床药师参与肠外营养相关性肝损害患者治疗的药学监护[J].中国药房,2017,28(17):2429-2432.
[10]林海鹏,卢晓明,管日戬,等.ω-3鱼油脂肪乳对老年胃癌患者术后恢复的影响[J].临床外科杂志,2016,24(12):907-909.