CAJ | 학술논문

目的研究ω-3鱼油脂肪乳对肝癌肝部分切除患者术后炎症反应、凝血功能及预后的影响.方法采用前瞻性随机对照研究方法,将80例肝细胞肝癌患者分为两组,肝部分切除术后给予两组患者等氮、等热量的肠外营养5d.鱼油组的脂肪乳中含80％的中长链脂肪乳和20％的ω-3(鱼油)脂肪乳；对照组的脂肪乳为中长链脂肪乳.比较两组患者的炎症反应、凝血功能以及预后情况.结果术后第3天鱼油组和对照组的C反应蛋白分别为(97.1 ±46.1)和(119.6±57.3) mg/L (P=0.016),术后第6天分别为(40.7±21.8)和(54.9±26.1) mg/L (P=0.018)；术后第3天鱼油组和对照组的血浆纤维蛋白原分别为(3.4±1.1)和(4.1±1.3) g/L (P＜0.001),术后第6天血浆纤维蛋白原分别为(3.3±0.9)和(3.8±1.2) g/L (P＜0.001),术后第3、6天时,鱼油组的血浆纤维蛋白原、C反应蛋白均显著低于对照组.术后第7天对照组和鱼油组的吲哚氰绿15 min滞留率分别为8.6％±4.9％和9.2％±7.3％,两组比较差异无统计学意义(P=0.179).术后随访半年,鱼油组和对照组的肿瘤复发率(40.63％比44.12％,x2 =0.082,P=0.774)及生存率(90.62％比88.24％,x2 ＜0.001,P=1.000)的差异均无统计学意义.结论 ω-3鱼油脂肪乳可能具有减轻肝癌肝切除术后患者炎症反应及一定的抗血栓形成作用.
목적 연구ω-3어유지방유대간암간부분절제환자술후염증반응、응혈공능급예후적영향.방법 채용전첨성수궤대조연구방법,장80례간세포간암환자분위량조,간부분절제술후급여량조환자등담、등열량적장외영양5d.어유조적지방유중함80％적중장련지방유화20％적ω-3(어유)지방유；대조조적지방유위중장련지방유.비교량조환자적염증반응、응혈공능이급예후정황.결과 술후제3천어유조화대조조적C반응단백분별위(97.1 ±46.1)화(119.6±57.3) mg/L (P=0.016),술후제6천분별위(40.7±21.8)화(54.9±26.1) mg/L (P=0.018)；술후제3천어유조화대조조적혈장섬유단백원분별위(3.4±1.1)화(4.1±1.3) g/L (P＜0.001),술후제6천혈장섬유단백원분별위(3.3±0.9)화(3.8±1.2) g/L (P＜0.001),술후제3、6천시,어유조적혈장섬유단백원、C반응단백균현저저우대조조.술후제7천대조조화어유조적신타청록15 min체류솔분별위8.6％±4.9％화9.2％±7.3％,량조비교차이무통계학의의(P=0.179).술후수방반년,어유조화대조조적종류복발솔(40.63％비44.12％,x2 =0.082,P=0.774)급생존솔(90.62％비88.24％,x2 ＜0.001,P=1.000)적차이균무통계학의의.결론 ω-3어유지방유가능구유감경간암간절제술후환자염증반응급일정적항혈전형성작용.
Objective To investigate the effects of ω-3 fatty acids on inflammation and coagulation function in hepatocellular carcinoma (HCC) patients after partial hepatectomy.Methods In this prospective randomized controlled trial,80 HCC patients were randomly divided into two groups based on the parenteral nutrition (PN) scheme that was provided 5 days after partial hepatectomy:fish oil group:20％ fish oil and 80％ mediumlong fatty acid; and control group:100％ medium-long fatty acid.The inflammation,liver function,blood coagulation indicators,and prognosis were compared between two groups.Results After 3 days of hepatectomy,the serum C-reactive protein levels in the control and fish oil groups were (119.6 ± 57.3) mg/L and (97.1 ± 46.1) mg/L(P =0.016),respectively; and on day 6 after surgery,C-reactive protein levels of two groups were (54.9 ± 26.1)and (40.7 ±21.8) mg/L,respectively (P =0.018).The plasma fibrinogen level in the fish oil group was significantly lower than that in the control group 3 days [(3.4 ± 1.1) vs.(4.1 ± 1.3) g/L,P ＜ 0.001] and 6 days [(3.3 ± 0.9) vs.(3.8 ± 1.2) g/L,P ＜ 0.001] after surgery.The retention rate of indocyanine green at 15 minutes on the 7th postoperative day were 8.6％ ±4.9％ and 9.2％ ±7.3％ in the control and fish oil groups,respectively (P=0.179).The recurrent rate (40.63％ vs.44.12％,x2 =0.082,P =0.774) and survival rate in the fish oil and control groups (90.62％ vs.88.24％,x2 ＜0.001,P =1.000) also showed no significant difference after 6 months of follow-up.Conclusion ω-3 fish oil emulsion can reduce postoperative inflammatory response and prevent thrombosis.