脂肪乳液为基础的早期亲肠道营养对患者在体肝切除术后的效果
Leyi Liao1, Yang Lei1, Qinghua He2
1Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
The British journal of nutrition
|March 24, 2025
概括
早期的脂肪乳液亲肠道营养可以通过减少肝酶和住院时间来改善血肝切除术后的恢复. 这种营养策略可以改善肝脏手术后患者的治疗结果.
科学领域:
- 肝胆道手术 肝胆道手术
- 临床营养学 临床营养学
- 胃肠病学 胃肠病学
背景情况:
- 亲肠道营养 (PN) 对接受肝脏重大手术 (如肝切除术) 的患者至关重要.
- 最佳PN成分,特别是早期使用脂肪乳液,仍然是一个需要临床澄清的领域.
- 了解PN对术后康复的影响对于改善患者的治疗结果至关重要.
研究的目的:
- 为了研究早期基于脂肪乳液的亲肠道营养 (PN) 与非脂肪PN相比,在经过血肝切除术后的患者中的有效性.
- 评估脂肪乳液PN对肝功能标志物,血液学参数和临床结果的影响.
- 评估特定脂肪成分,如n-3鱼油,对术后恢复和并发症的影响.
主要方法:
- 追溯分析了571名患者 (274名非脂肪PN组,297名脂肪乳液PN组) 的临床数据,这些患者接受了血肝切除术.
- 两组之间的术后肝功能测试 (AST,胆红素),血细胞计数,住院时间,禁食时间和并发症率的比较.
- 亚组分析侧重于n-3鱼油丰富乳液对炎症标志物和感染风险的影响.
主要成果:
- 基于脂肪乳液的早期PN显著降低了术后的阿斯巴酸氨基转移酶,总胆红素和直接胆红素水平.
- 接受脂肪乳液PN的患者经历了手术后更短的住院时间和禁食时间.
- 短期术后并发症发生率没有显著差异;然而,n-3鱼油补充剂与减少炎症和感染风险有关.
结论:
- 早期服用基于脂肪乳液的亲肠道营养可促进经过肝切除术后患者的短期术后康复.
- 脂肪乳液PN对肝功能产生积极影响,并加速临床康复,而不会增加并发症率.
- 这些发现支持使用基于脂肪乳液的PN,特别是与n-3脂肪酸一起,以优化肝切除后的恢复.
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