ω-3多不饱和脂肪酸对腹腔镜结直肠癌术后的影响

探讨围手术期序贯应用ω-3多不饱和脂肪酸（ω-3PUFA）对腹腔镜结、直癌患者术后炎症反应及临床疗效的影响。方法选取2014 年2 月-2015 年5 月于海南省海口市人民医院胃肠外科确诊并行腹腔镜结、直癌根治术的患者。将符合标准的患者随机分至实验组（静脉营养制剂中加入ω-3PUFA）和对照组（静脉营养制剂中不添加ω-3PUFA）。比较两组患者入院时及术后第1和6天血清炎症反应因子（C反应蛋白、降钙素原、白介素6）和营养学相关指标（白蛋白、前白蛋白、视黄醇结合蛋白和转铁蛋白）水平，及其他临床相关指标。结果不同时间的C 反应蛋白、降钙素原、白介素6 水平比较，差异有统计学意义（p <0.05）；两组C反应蛋白、降钙素原、白介素6 水平比较，差异有统计学意义（ p<0.05），实验组与对照组比较，在术后第6 天炎症因子水平较低，相对控制炎症效果较好；两组炎症因子变化趋势比较，差异有统计学意义（ p<0.05）。结论围手术期序贯应用ω-3PUFA可以抑制结、直肠癌术后炎症因子的释放，降低术后并发症发生率及级别，促进术后恢复。

Effect of omega-3 polyunsaturated fatty acids on inflammatory reaction after laparoscopic surgery for colorectal cancer

To investigate the effect of omega-3 polyunsaturated fatty acids (PUFA) on postoperative inflammatory response and clinical efficacy in colorectal cancer patients with laparoscopic surgery. Methods All the patients with colorectal cancer undergoing laparoscopic surgery in our department from February 2014 to May 2015 were prospectively enrolled in the study. The patients who matched the selection criteria were randomly divided into two groups: trial group (with omega-3 PUFA in parenteral nutrition preparations) and control group (without omega-3 PUFA in parenteral nutrition preparations). Levels of inflammatory factors (serum CRP, procalcitonin and IL-6) and nutrition-related proteins (albumin, prealbumin, retinol conjugated protein and transferrin) were compared between the two groups before operation and on the 1st and 6th day after operation. Other clinically relevant indicators were compared between the two groups as well. Results There were no significant differences in inflammatory factors or nutrition related proteins between the two groups before operation ( p> 0.05). The levels of C reactive protein, procalcitonin and IL-6 were significantly different at different time points ( p<0.05). There were significant differences in the levels of C reactive protein, procalcitoninand IL-6 between the two groups (p <0.05). On the 6th day after operation, the levels of inflammatory cytokines, including CRP, procalcitonin and IL-6 in the trial group were significantly lower than those of the controlgroup (p < 0.05). The variation trends of inflammatory factors were significantly different between the two groups( p< 0.05). Conclusions Omega-3 PUFA can reduce the release of inflammatory factors, lower the incidences of postoperative complications, and expedite postoperative recovery.