经皮肝穿胆道支架置入减黄术前鱼油脂肪乳的应用方法与效果分析

摘要

目的 探讨经皮肝穿胆道支架置入减黄术前鱼油脂肪乳的应用方法与效果.方法 选择2013年9月～2016年2月选择在空军总医院诊治的恶性梗阻性黄疸患者156例,随机数字表法分为观察组与对照组,每组各78例.所有患者均行经皮肝穿胆道支架置入减黄手术治疗,观察组给予口服鱼油脂肪乳辅助治疗,对照组给予静脉输注鱼油脂肪乳辅助治疗,从术前5d开始口服、输注营养液至手术日,观察两组术后情况.结果 观察组累计正氮平衡明显多于对照组(P＜0.05).观察组术后l、12d的血清白介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)水平明显低于对照组(P＜0.05),且术后12d的血清IL-6与TNF-α水平明显低于术后1 d(P＜ 0.05).两组术后均无死亡病例,观察组术后并发症发生率与术后住院时间都明显少于对照组(P＜ 0.05).结论 恶性梗阻性黄疸减黄术前采用口服鱼油脂肪乳支持治疗能有效改善患者的肝功能与炎症表达状况,有助于促进患者恢复、减少并发症的发生,有很好的应用价值.%Objective To investigate the application method and effect of fish oil fat emulsion before percutaneous transhepatic biliary stent placement.Methods From September 2013 to February 2016,in Air Force General Hospital of PLA,156 patients with malignant obstructive jaundice were selected,according to radomnumber table,they were divided into observation group and control group,with 78 cases in each group.All patients were given percutaneous transhepatic biliary stent placement operation,the observation group were given oral fish oil fat emulsion support treatment,the patients in the control group were given intravenous infusion of fish oil fat emulsion support treatment,the support treatment was from 5 d before the operation to the day of surgery,the presentation of the two groups after operation were observed.Results The cumulative nitrogen balance in the observation group was significantly more than that in the control group (P ＜ 0.05).The serum IL-6 and TNF-α in the observation group at postoperative 1,12 d were significantly lower than those in the control group (P ＜ 0.05),and the serum IL-6 and TNF-α at postoperative 12 d were were significantly lower than those at the postoperative 1 d (P ＜ 0.05).There was no dead case in two groups,the incidence rate of postoperative complications and the hospital stay time in the observation group were significantly less than those of the control group (P ＜ 0.05).Conclusion Before operation,oral fish oil fat emulsion support therapy before percutaneous transhepatic biliary stent placement operation can effectively improve the patient's liver function and nutritional status,promote the patients recovery,reduce complications occurred,it has very good application values.