摘要
目的 比较含ω-3多不饱和脂肪酸(ω-3 PUFA)的不同脂肪乳剂治疗重症患者的疗效.方法 回顾性分析安徽医科大学附属六安医院2018年5月至2023年5月接受含ω-3 PUFA的脂肪乳剂治疗重症患者临床资料,根据全肠外营养处方中不同脂肪乳构成,分为多种油脂肪乳组和ω-3鱼油脂肪乳联合长链或中/长链脂肪乳组,比较两组总住院时间、ICU入住时间、脂肪乳总费用、住院总费用、全肠外营养治疗总费用、药品费用占比、保肝药物使用率、患者好转率、总胆红素、白蛋白、AST、ALT、WBC计数、中性粒细胞百分比及C反应蛋白水平.结果 共纳入多种油脂肪乳组106例,ω-3鱼油指肪乳联合长链或中/长链脂肪乳组76例.治疗后,两组患者的总住院时间、ICU入住时间、住院总费用、保肝药物使用率及患者好转率比较,差异均无统计学意义(P>0.05);与ω-3鱼油脂肪乳联合长链或中/长链脂肪乳组比较,多种油脂肪乳组可降低脂肪乳总费用、全肠外营养治疗总费用及药品费用占比,差异均有统计学意义(P<0.05);两组患者肝功能和炎症指标水平比较,差异均无统计学意义(P>0.05).结论 在重症患者全肠外营养处方设计时,在控制药品费用占比的情况下,可用多种油脂肪乳替代ω-3鱼油脂肪乳联合长链或中/长链脂肪乳,2种处方临床疗效并无差异.
Abstract
Objective To compare the efficacy of fat emulsions containing ω-3 polyunsaturated fatty acids(ω-3 PUFA)in the nutritional support of critically ill patients.Methods A retrospective analysis was conducted on the clinical data of criti-cally ill patients treated with containing ω-3 PUFA-based fat emulsions in Lu'an Hospital Affiliated to Anhui Medical Universi-ty from May 2018 to May 2023.According to the total parenteral nutrition(TPN)prescription of different fat emulsions compo-sition,patients were divided into multi-oil lipid emulsion group and ω-3 fish oil lipid emulsion combined with long or medi-um/long chain lipid emulsion group.The total hospitalization stay,ICU stay duration,total cost of lipid emulsion,total hospi-talization cost,total cost of TPN treatment,proportion of medical costs,hepatoprotective drug usage rate,patient improve-ment rate,total bilirubin,albumin,AST,ALT,WBC count,neutrophils percentage,and C-reactive protein(CRP)levels were compared between the two groups.Results A total of 106 cases were included in the multi-oil lipid emulsion group and 76 cases in the ω-3 fish oil lipid emulsion combined with long or medium/long chain lipid emulsion group.After treatment,there were no significant differences in total hospitalization stay,ICU stay duration,total hospitalization cost,hepatoprotective drug usage rate of and patient improvement rate between the two groups(P>0.05).Compared with the ω-3 fish oil lipid emul-sion combined with long or medium/long chain lipid emulsion group,the multi-oil liupid emulsion group showed significant reductions in total lipid emulsion cost,total TPN treatment cost,and the proportion of medication costs(P<0.05).No signifi-cant differences were observed between the two groups in the improvement of liver function and inflammatory index levels(P>0.05).Conclusion In the design of TPN prescriptions for critically ill patients,using the multi-oil lipid emulsion can replace ω-3 fish oil lipid emulsion combined with long or medium/long chain lipid emulsion to control the proportion of medication costs,with no difference in clinical efficacy between the two prescriptions.
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