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The Effection of Intravenous Fish Oil Combined with Enteral Nutrition to the Patients of NRS2002≥3 after Abdominal Surgery

Author: HuangXiaoLing
Tutor: XuPengYuan
School: Kunming Medical College
Course: Surgery
Keywords: Fish oil Nutritional Risk Screening Inflammatory mediators Bowel function Abdominal surgery
CLC: R459.3
Type: Master's thesis
Year: 2011
Downloads: 18
Quote: 0
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Abstract

Objective To investigate the impact of inflammatory cytokines NRS2002 ≥ 3 patients after abdominal surgery, intestinal function and clinical outcome of intravenous fish oil and enteral nutrition. Select from September 2010 to March 2011 the Second Affiliated Hospital of Kunming Medical College, dry treatment surgical hospital received NRS2002 ≥ 3 points and elective abdominal surgery patients 40 cases, including 10 cases of patients with cholecystectomy and bile duct exploration lithotomy patients with 12 cases, 10 cases of left the extrahepatic lobe resection patients knot, eight cases of patients with rectal cancer radical surgery. Patients were stratified according to different surgical categories were randomly divided into a control group, 20 patients (5:6:5:4) and the fish oil group 20 patients (5:6:5:4). All patients were under general anesthesia laparotomy. The two groups of patients after the supply of nutrients to the heat of early enteral and parenteral nutrition were given 2-3d transition to full enteral nutrition unit weight nitrogen (PN EN sum) supply. The two groups of patients in the preoperative 1d, after the first day and 6d fasting pumping blood plasma IL-10, TNF-α, D-lactate concentration was measured; records first postoperative anal exhaust time, complications and surgery after hospitalization time. Results of TNF-α, IL-10, D-lactic acid comparison (1) of TNF-α compare ① control group group comparison: 1d and 1d compared differences in preoperative patients with statistical significance (P lt; 0.01), after 6d preoperative 1d compared the difference was statistically significant (P lt; 0.05); postoperative 6d difference was statistically significant (P lt; 0.01) compared with the postoperative 1d. The control group patients 1dTNF-α significantly increased after 6d has not yet returned to preoperative levels. ② the fish oil group group comparison: with preoperative patients 1d 1d than the difference was statistically significant (P lt; O.01) after 6d with preoperative 1d difference had no statistical significance (P gt; 0.05 ); postoperative 6d difference was statistically significant (P lt; 0.01) compared with postoperative 1d. Fish oil group patients 1dTNF-α were significantly increased after 6d returned to preoperative levels. ③ between the two groups: two groups of patients before surgery 1d, 1d after group difference was statistically significant (P gt; 0.05), compared with postoperative 6d difference had statistical significance (P lt; 0.05). Patients in both groups were lower, the fish oil group decreased significantly. (2) ① control group of IL-10 group comparison: 1d and 1d compared differences in preoperative patients was statistically significant (P lt; 0.01) after 6d difference compared with preoperative 1d Statistics significance (P lt; 0.01); postoperative 6d difference compared with the postoperative 1d statistical significance (P lt; 0.01). Control group patients 1d IL-10 significantly increased after 6d than after the first 1d elevated. ② the fish oil group group comparison: patients 1d preoperative, 1d compared the difference was statistically significant (P lt; O.01), compared with the preoperative 1d after 6d difference was statistically significance (P lt; 0.01); postoperative 6d difference was statistically significant (P lt; 0.01) compared with the postoperative 1d. Fish oil group patients 1d IL-10 significantly increased after 6d than after the first 1d elevated. ③ comparison between groups: two groups of patients before surgery 1d, between postoperative 1d group compared the difference was not statistically significance (P gt; 0.05), postoperative first 6d difference was statistically significance (P lt; 0.05) . Patients in both groups were continuing to rise, and the control group increased more significantly. (3) group of D-lactic acid comparison ① control group comparison: 1d and 1d compared differences in preoperative patients was statistically significant (P lt; 0.01) after 6d difference compared with preoperative 1d Statistics significance (P lt; 0.01); postoperative 6d compared with postoperative 1d differences had no statistical significance (P gt; 0.05). Patients in the control group after the first day D-lactic acid significantly increased after 6d not changed significantly compared with postoperative 1d. ② the fish oil group group comparison: 1d and 1d compared differences in preoperative patients was statistically significant (P lt; 0.01) after 6d difference compared with the preoperative 1d statistical significance (P lt; 0.01 ); postoperative 6d difference was statistically significant (P lt; 0.05) compared with postoperative 1d. The fish oil group were the first day after D-lactic acid was significantly higher than after the first 1d after 6d significantly reduced, but not yet returned to preoperative levels. ③ group comparison: the fish oil group and the control group preoperative 1d, 1d after group compared the difference was not statistically significant (P gt; 0.05); postoperative 6d difference compared with statistical significance (P lt; 0.05). Patients in both groups compared with postoperative 1d reduce the fish oil group significantly decreased. Clinical indicators were compared in patients with postoperative complication rate compared with no significant difference (P gt; 0.05), two groups the incidence of infectious complications compared the difference was statistically significant (P lt; 0.05) compared to the two groups of patients with non-infectious complication rate difference was not statistically significant (P gt; 0.05); the first postoperative Exhaust compared the difference was statistically significant (P lt; O.05); two postoperative hospital stay of patients compared the difference was statistically significant (P lt; 0.05). Conclusion 1 ≥ 3 NRS2002 of abdominal surgery patients exist inflammatory response, fish oil can reduce the levels of inflammatory mediators; intravenous fish oil and enteral nutrition can reduce the levels of D-lactate NRS2002 ≥ 3 patients after abdominal surgery, to improve the mucosal barrier function to promote the recovery of intestinal function; intravenous fish oil and enteral nutrition can shorten NRS2002 ≥ 3 patients after abdominal surgery, the first exhaust the time and postoperative hospital stay, reduce the incidence of postoperative infectious complications and improve clinical outcomes.

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