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目的:探讨含ω-3鱼油脂肪乳的肠外营养(PN)液对胃肠道肿瘤病人术后免疫、炎性反应、肿瘤相关因子的表达和感染并发症的发生率等方面的影响。方法:选取胃肠道肿瘤病人88例,随机分为对照组和研究组。对照组给予低热量PN治疗,研究组在此基础上加用ω-3鱼油脂肪乳。分别测定手术前1天和术后第6天外周血总淋巴细胞计数(TLC)、CD3、CD4、CD8、CD4/CD8、WBC、C反应蛋白(CRP)、IL-6、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)等免疫、炎症和肿瘤相关因子的指标,并比较两组病人感染并发症的发生率。结果:经术后6 d的PN治疗,两组病人间的免疫功能、炎性反应水平有显著性差异(P<0.01,P<0.05)。研究组病人的免疫功能明显改善、机体炎性反应水平明显降低。术后研究组VEGF、IGF-1表达下降幅度大,其中IGF-1与对照组相比,有显著性差异(P<0.05)。结论:胃肠道肿瘤术后病人在PN液中添加ω-3鱼油脂肪乳治疗后,免疫功能得到明显改善,炎性因子的释放受到抑制,感染并发症发生率下降,降低了肿瘤相关因子的表达。
Objective: To investigate the effects of parenteral nutrition (PN) fluid containing ω-3 fish oil fat emulsion on postoperative immunity, inflammatory response, tumor-related factor expression and infection complication rate in gastrointestinal cancer patients. Methods: 88 patients with gastrointestinal cancer were selected and randomly divided into control group and study group. The control group given low calorie PN treatment, the study group on the basis of the use of ω-3 fish oil fat emulsion. Peripheral blood total lymphocyte count (TLC), CD3, CD4, CD8, CD4 / CD8, WBC, C-reactive protein (CRP), IL-6 and tumor necrosis factor- (TNF-α), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1) and other immune, inflammation and tumor related factors, and compared the incidence of complications in two groups of patients. Results: After 6 days of PN treatment, there were significant differences in immune function and inflammatory response between the two groups (P <0.01, P <0.05). The immune function of study group patients was significantly improved, the level of inflammatory response was significantly reduced. There was a significant decrease in the expression of VEGF and IGF-1 in postoperative study group, and there was significant difference between IGF-1 and control group (P <0.05). CONCLUSIONS: After the operation of gastrointestinal cancer patients treated with omega-3 fish oil emulsion in PN fluid, the immune function was significantly improved, the release of inflammatory factors was inhibited, the incidence of infectious complications was decreased, and the tumor-associated factor expression.