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J hepatology: 围手术期omega-3脂肪酸不能在肝脏手术中提供保护

2020-03-16 MedSci原创 MedSci原创

在多种动物模型中,omega-3多不饱和脂肪酸(Ω3-FAs)具有很强的保护作用,可减轻肝脏缺血/再灌注损伤和脂肪变性,并增强主要组织损失后的再生能力。鉴于这些好处及其安全性,

背景与目标:在多种动物模型中,omega-3多不饱和脂肪酸(Ω3-FAs)具有很强的保护作用,可减轻肝脏缺血/再灌注损伤和脂肪变性,并增强主要组织损失后的再生能力。鉴于这些好处及其安全性,本项研究假设在接受肝脏手术的患者中围手术期使用Ω3-FAs可能会改善术后过程。这项研究的目的是研究围手术期使用Ω3-FAs减少肝脏手术后的术后并发症。

方法:在2013年7月至2018年7月之间,研究人员进行了一项多中心,双盲,随机,安慰剂对照试验,旨在测试Omegaven?(Ω3-FAs)与安慰剂的2次单次静脉输注是否可以降低术后并发症发病率。主要终点是根据综合并发症指数(CCI)综合严重程度(Clavien-Dindo分类)的术后并发症。

结果:该试验共纳入了来自3个中心的261名患者(Omegaven中为132名患者,安慰剂组为129名患者)。大多数病例(87%,n = 227)接受了开放性肝手术,其中56%(n = 105)为大手术(≥3个部分)。在Ω3-FAs和安慰剂组的死亡率分别为4%和2%(比值比为0.40; 95%CI为0.04-2.51;p = 0.447)。在Ω3-FAs组和安慰剂组中,任何并发症和主要并发症(Clavien-Dindo≥3b)分别发生在46%vs. 43%(p = 0.709)和12%vs. 10%(p = 0.69)。平均CCI为17(±23)vs.14(±20)(p = 0.417)。

结论:肝手术患者不建议常规围手术期使用静脉内Ω3-FAs注射剂。

原始出处:

Michael Linecker. Et al. Perioperative omega-3 fatty acids fail to confer protection in liver surgery: Results of a multicentric, double-blind, randomized controlled trial. J Hepatology.2020.

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    2020-03-18 gwc384
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    2020-03-16 xcdnxj

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