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Multiple organ dysfunction syndrome (MODS) patients or intestinal failure due to infection and other factors,intestinal dysfunction can not complete the absorption of nutrients and electrolytes.Progressive malnutrition in severe patients usually develops rapidly.Early parenteral nutrition can significantly improve the prognosis of MODS patients.PN is now widely used in all kinds of severe patients,but parenteral nutrition-associated liver disease (PNALD) caused by parenteral nutrition is prevalent in such patients.The emergence of PNALD increases the difficulty of curing patients' diseases.Many studies have found thatω-3fish oil fat emulsion in nutrient solution is an effective way to prevent and improve PNALD.
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Objective To investigate the application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer.Methods The retrospective cohort study was conducted.The clinical data of 60 patients who underwent radical gastrectomy for gastric cancer in Nanjing Medical University Affiliated Wuxi Second Hospital between January 2018 and December 2018 were collected.There were 37 males and 23 females,aged from 28 to 78 years,with an average age of 64 years.Thirty patients who received parenteral nutrition containing 100 mL of ω-3 fish oil fat emulsion after radical gastrectomy and 30 patients who received parenteral nutrition containing routine fat emulsion after radical gastrectomy were allocated into experimental group and control group,respectively.Observation indicators:(1) nutritional indicators in the perioperative period;(2) inflammatory indicators in the perioperative period;(3) immune indicators in the perioperative period;(4) postoperative complications.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was evaluated using the independent-sample t test.Count data were described as absolute numbers and percentages,and comparison between groups was analyzed using the chi-square test.Repeated measurement data were analyzed by the repeated measures ANOVA.Results (1) Nutritional indicators in the perioperative period:the levels of total protein,albumin,prealbumin,and transferrin from preoperative day 1 to preoperative day 6 were respectively changed from (60.2±3.0)g/L to (57.2± 3.1)g/L,from (35.3±3.1)g/L to (37.0±1.8)g/L,from (186±24)mg/L to (172±17)mg/L,from (3.0± 0.7) g/L to (2.4 ± 0.4) g/L in the experimental group and from (60.6± 2.4) g/L to (55.7 ± 4.2) g/L,from (35.0±3.8)g/L to (36.0±3.8) g/L,from (184±18)mg/L to (173±25)mg/L,from (3.1±0.6)g/L to (2.2± 0.8)g/L in the control group,with no significant difference in the changing trends between the two groups (F=0.79,2.14,0.03,0.36,P＞0.05).(2) Inflammatory indicators in the perioperative period:the levels of white blood cells,C-reactive protein,interleukin 6,and tumor necrosis factor-α from preoperative day 1 to preoperative day 6 were respectively from (7.2±1.1) ×109/L to (10.2±0.9) ×109/L,from (7.2±2.3) mg/L to (25.5±6.3) mg/L,from (16± 3) ng/L to (24± 4) ng/L,from (17± 4) ng/L to (22± 5) ng/L in the experimental group and from (7.4±0.8) × 109/L to (13.0±1.3) × 109/L,from (6.9±2.4) mg/L to (41.6± 18.9) mg/L,from (17±4) ng/L to (45±8)ng/L,from (16±4)ng/L to (43±7)ng/L in the control group,respectively,with significant differences in the changing trends between the two groups (F=63.05,51.65,127.82,104.91,P＜0.05).(3) Immune indicators in the perioperative period:the levels of immunoglobulin A,immunoglobulin G,immunoglobulin M,CD4+,CD8+,and ratio of CD4+/CD8+ from preoperative day 1 to preoperative day 6 were respectively from (1.5±0.4)g/L to (2.8±0.5)g/L,from (11.1±1.7)g/L to (14.0±1.2)g/L,from (0.77± 0.28)g/L to (1.61±0.31)g/L,from 42％±6％ to 46％±5％,from 23％±4％ to 24％±3％,from 1.82±0.42 to 2.11±0.24 in the experimental group and from (1.4±0.4) g/L to (2.3±0.6) g/L,from (10.7± 1.8) g/L to (11.9± 1.4)g/L,from (0.69±0.23)g/L to (1.19±0.33)g/L,from 40％±5％ to 39％±4％,from 24％±3％ to 23％±3％,from 1.75±0.34 to 1.81±0.35 in the control group,respectively,showing significant differences in the changing trends of the levels of immunoglobulin A,immunoglobulin G,immunoglobulin M,CD4+,and ratio of CD4+/CD8+ between the two groups (F=18.39,15.20,38.42,9.55,5.50,P＜0.05),showing no significant difference in the changing trend of the levels of CD8+ between the two groups (F =0.89,P ＞ 0.05).(4)Postoperative complications:5 patients had postoperative complications,with a incidence rate of 16.7％ (5/30),including 1 of abdominal infection,1 of incisional infection,and 3 of pulmonary infection,and all the 5 patients were cured after symptomatic treatment.Nine patients had postoperative complications,with a incidence rate of 30.0％(9/30),including 2 of abdominal infection,2 of incisional infection,and 5 of pulmonary infection,and all the 9 patients were cured after symptomatic treatment.There was no significant difference in the incidence of postoperative complications between the two groups (x2 =1.491,P＞0.05).Conclusion For patients who receive gastric cancer surgery,ω-3 fish oil fat emulsion can reduce the inflammatory response,improve their immune function and not increase postoperative complications.
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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.
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Objective: To investigate the effects of ω-3 fish oil fat emulsion on nutritional status and humoral immunity in postoperative patients suffering from gastrointestinal malignancy. Methods: Thirty patients of gastrointestinal malignancy were randomly divided into study group (n = 15) and control group (n = 15). All the patients were assigned to receive total parenteral nutrition with the equal nitrogen and calory,and those in study group received fish oil fat emulsion additionally. Liver and renal function, blood lipid, haemoglobin, albumin, transferrin, total lymphocyte count (TLC) , B lymphocyte subsets (B1, B2), immunoglobin(IgG, IgM, IgA) and complement(C3, C4) were determined preoperatively and 1, 6d postoperatively. Results: There were no significant differences in liver and renal function and blood lipid on postoperative day 6 versus preoperation in all the two groups. TLC, IgG, IgM, C3 on postoperative day 6 were siginificantly higher in the study group(P < 0. 05). Haemoglobin, albumin, transferrin and B lymphocyte subsets were not significantly different between the two groups. Conclusion: Fish oil fat emulsion treatment was safe and tolerated, and could improve the humoral immunity in patients.
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The aim of this study was to explore the effects of parenteral supplementation with ω-3 fish oil emulsion (Omegaven ) on systemic inflammatory response syndrome (SIRS) during the ini-tial stage of severe acute pancreatitis (SAP).In a prospective,randomized and controlled trial,60 pa-tients with SAP were randomized either to treat with conventional therapy (Con group,n=30) or conventional therapy plus intravenous supplementation with 0-3 fish oil emulsion 0.2 g/kg every day (FO group,n=30).The effects were analyzed by the SIRS-related indexes.The results showed that APACHE-II scores in FO group were significantly lower,and the gap increased much farther after the 4th day than those in Con group (P<0.05).Fluid equilibrium time became shorter markedly in FO group than in Con group (5.1±9.2 days vs 8.4±2.3 days).In FO group,SIRS scores were markedly duced,while IL-10 decreased markedly,most prominently between the 4th and 7th day,and the ratio euteral supplementation with ω-3 fish oil emulsion could efficiently lower the magnitude and persis-tence time of the SIRS,markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines,im-prove severe condition of illness and may provide a new way to regulate the SIRS.
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and persistence of the SIRS,retrieve the unbalance of the pro-/anti-inflammatory,and improve the severe disease conditions.Therefore,it provides a new and feasible way to reglate SIRS in the early phase of SAP.