静脉补充鱼油脂肪乳对呼吸科ICU患者炎症反应治疗作用观察

摘要

[Objective] To investigate the influence of ω-3 fatty acids fish oil fat emulsion on the respiratory system inflammation in critically ill patients to provide the basis for clinical treatment.[Method] Totally 55 respiratory critically ill patients in Xinqiao Hospital ICU with IMV were erolled,the test group had 26 patients,the control group had 29 patients.In addition to adopt conventional treatment.All the patients were assigned to receive a isonitrogenic and isocalorie nutritional support,energy 30 kcal/ (kg · d) and protein 1.2g/ (kg · d),which was enteral nutrition combined with parenteral nutrition.Patients in study group were treated with Enteral nutrition combined with adding ω-3 fatty acids,fish oil fat emulsion parenteral nutritional support,the control group patients,who used enteral nutrition combined with Parenteral nutritional support without ω-3 fatty acids in fish oil fat emulsion.Extracting peripheral blood of the two groups of patients before using the nutritional support 1 day and after 6 days,and measuring inflammation indicators:C-reactive protein (CRP) levels was detcted by turbidimetric inhibition immuno assay,tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels was by ChemiLuminescence.At the same time we recorded the length of ICU stay and the duration of mechanical ventilation.[Result] Before nutritional supported there were no significant different of CRP,TNF-α,IL-6 (P ＞0.05) between test group and control group,but after nutritional supported 6 days,all the inflammation indicators of the study group patients decreased,and compared with two groups results showed that the levels of serum CRP,TNF-α,IL-6 were significant difference (P ＜0.05),the test group was significantly lower than the control group.The duration of mechanical ventilation was significantly different from the control group (P ＜ 0.05).The length of ICU was not significantly different between two groups (P ＞ 0.05).[Conclusion] ω-3 fatty acids fish oil fat emulsion can improve respiratory system inflammation in critically ill patients,which is benefical for hort the duration of mechanical ventilation.%目的:探讨静脉补充鱼油脂肪乳对呼吸科ICU患者炎症反应的治疗作用.方法:选取在新桥医院呼吸科重症ICU住院并行IMV呼吸机辅助呼吸患者55例,分为2组,试验组26例、对照组29例,除采用常规治疗外,2组均采用等氮等热量肠内营养结合静脉营养给予营养支持,试验组患者给予肠内营养联合添加鱼油脂肪乳静脉营养支持,对照组给予肠内营养联合未添加鱼油脂肪乳静脉营养支持.两组患者分别在使用营养支持前1天和支持后第6天检测炎症反应指标C反应蛋白(CRP)水平,肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,记录患者入住ICU时间、机械通气天数.结果:2组患者手术前CRP、TNF-α、IL-6无显著性差异(P＞0.05).使用营养支持后第6天试验组炎症反应指标CRP、TNF-α、IL-6浓度显著低于对照组,有统计学差异(P＜0.05),机械通气时间明显缩短(P＜0.05)、入住ICU时间无统计学差异(P＞0.05).结论:鱼油脂肪乳能够改善呼吸系统危重症患者的炎症反应,并有益于缩短机械通气天数.