ω-3多不饱和脂肪酸在治疗重度颅脑外伤并发肺部感染中的临床应用

    Clinical application of ω-3 polyunsaturated fatty acids in severe brain injury complicated by lung infection

    • 摘要: 目的:观察ω-3多不饱和脂肪酸(polyunsaturated fatty acids,PUFAs)在重度颅脑外伤并发肺部感染治疗中的应用效果。方法:将56例重度颅脑外伤并发肺部感染的患者随机均分为对照组和干预组,干预组在对照组治疗的基础上加用ω-3PUFAs。2组患者均完善相关检查,常规治疗为抗感染、脱水降颅压等,均建立人工气道(气管插管或气管切开)及机械通气,均给予能量补充105~125 kJ·kg-1·d-1,干预组中部分热量由ω-3PUFAs的脂肪乳剂来提供。分别于治疗前及治疗第2、4、7天监测患者当日最高体温、呼吸频率、心率、白细胞计数及氧合指数,比较2组患者的预后、ICU停留时间、呼吸机使用时间和ICU期间的费用。结果:2组的临床指标在第2天比较差异无统计学意义(P>0.05);2组患者的生命体征和白细胞计数均呈下降趋势,氧合指数呈上升趋势,与时间呈相关性,干预组在第4和7天较对照组更明显,差异均有统计学意义(P<0.05~P<0.01);第7天观察患者预后转归,2组差异无统计学意义(P>0.05);在呼吸机使用时间、ICU停留时间及费用差异均有统计学意义(P<0.01)。结论:ω-3PUFAs对重度颅脑外伤并发肺部感染患者机体有一定的保护作用。

       

      Abstract: Objective:To observe therapy effect of ω-3 polyunsaturated fatty acids in severe brain injury complicated by lung infection. Methods:Fifty-six cases of severe brain injury in patients with pulmonary infection were randomly divided into control group and Ewing group. Before division, all the patients were given the relevant examination and treatments such as antibiotics, reducing intracranial pressure,as well as endotracheal intubation, ventilator application and post-tracheotomy. Both groups were given energy supplement 105~125 kJ·kg-1·d-1,but in Ewing group,some of the heat were provided by the fat emulsion of ω-3 fatty acids. On the 0th,2nd,4th and 7th day patients'maximum day temperature,respiratory rate,heart rate,white blood cell,oxygenation index were monitored,and finally prognosis,ICU stay time,ventilation time and an average cost of the two groups of patients during ICU stay time were recorded. Results:The control group and Ewing group with positive anti-infection treatments are getting better. Clinical indicators of Ewing group and the control group on the 2nd day were not statistically significant(P>0.05). The vital signs(temperature,heart rate,respiration) and white blood cells of the two groups of patients showed downward trend over time,while the oxygenation index showed an upward trend over time,which is more significant for Ewing group on the 4th and 7th day compared with the control group, and the difference was statistically significant(P<0.05-P<0.01). After the 7-day observation in the prognosis outcome,the two groups showed no significant differences,not statistically significant(P>0.05). However,in the average ventilator time,ICU length of stay and cost,the two groups has significant differences,with statistical significance(P<0.01). Conclusions:ω-3 polyunsaturated fatty acids on severe brain injury in patients with pulmonary infection in the body has a protective effect.

       

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