ω-3多不饱和脂肪酸治疗结直肠癌术后合并脓毒症休克患者疗效观察

摘要

目的：观察ω-3多不饱和脂肪酸治疗结直肠癌术后合并脓毒症休克患者的临床疗效。方法选择2012年1月至2016年4月期间我院重症监护室收治的30例结直肠癌术后合并脓毒症休克患者为研究对象，根据随机数字表法分为对照组和观察组，每组15例。对照组患者予常规肠外营养支持治疗，观察组在此基础上联合应用ω-3多不饱和脂肪酸治疗，疗程5 d。观察并比较两组患者治疗前后的血清白蛋白(Alb)、C反应蛋白(CRP)水平及急性生理学与慢性健康状况Ⅱ评分(APACHEⅡ)，并比较住ICU时间及28 d病死率。结果治疗后，观察组与对照组患者血清Alb分别为(35.7±2.6) g/L、(32.4±2.8) g/L，均较治疗前有明显提高，差异均有统计学意义(P<0.05)；观察组与对照组患者血清CRP及APACHEⅡ评分分别为(19.7±4.5) mg/L、(12.4±2.1)分和(31.6±9.8) mg/L、(14.3±2.5)分，均有显著降低，差异均有统计学意义(P<0.05)；观察组患者住ICU时间为(9.6±1.3) d，明显短于对照组的(12.1±2.2) d，差异有统计学意义(P<0.05)；两组患者28 d病死率比较差异无统计学意义(P>0.05)。结论ω-3多不饱和脂肪酸应用于结肠癌术后合并脓毒症休克患者的肠外营养支持治疗，可以改善患者营养状况，抑制炎症反应、促进机体的康复。%Objective To investigate the clinical efficacy of ω-3 polyunsaturated fatty acids in patients with colorectal cancer complicated with septic shock. Methods A total of 30 patients with colorectal cancer complicated with postoperative septic shock, who admitted to ICU of our hospital from January 2012 to April 2016, were selected and randomly divided into two groups according to the random number table method, with 15 cases in each group. The control group received conventional intestinal parenteral nutrition support treatment;the observation group was treated with conventional intestinal parenteral nutrition support treatment combined with ω-3 polyunsaturated fatty acids. The two groups were treated for 5 days. The score changes of serum albumin (Alb), C-reactive protein (CRP) and acute phys-iology and chronic health evaluation Ⅱ (APACHE Ⅱ) before and after treatment between the two groups were com-pared, and ICU time and 28-day mortality rate were compared too. Results After treatment, the serum Alb in the obser-vation group and the control group were respectively (35.7±2.6) g/L and (32.4±2.8) g/L, which were significantly higher than before treatment, and the level in the observation group was significantly higher than that in the control group. The differences were of statistically significance (P<0.05). The serum CRP and APACHEⅡscore in the observation group and the control group were (19.7 ± 4.5) mg/L, (12.4 ± 2.1) points, (31.6 ± 9.8) mg/L and (14.3 ± 2.5) points, respectively, which all decreased significantly, and those in the observation group were significantly lower than in the control group. The differences were statistically significant (P<0.05). The ICU time in the observation group was (9.6 ± 1.3) d, which was significantly shorter than (12.1±2.2) d in the control group (P<0.05). There was no statistically significant difference in 28-day mortality rate between the two groups (P>0.05). Conclusion The application ofω-3 polyunsaturated fatty ac-ids combined with parenteral nutrition support therapy in patients with colorectal cancer with postoperative septic shock can improve the nutritional status of patients, inhibit inflammatory response and promote the recovery of the body.