针对性营养干预对行直肠癌根治手术患者排便功能及术后并发症的影响  

Effect of targeted nutrition intervention on defecation and postoperative complications in patients undergoing radical resection for rectal cancer

作　　者：孙秋月 周建英[2] 杜丽云[2] Qiu-Yue Sun;Jian-Ying Zhou;Li-Yun Du(Department of General Surgery,Deqing People＇s Hospital,Huzhou 313200,Zhejiang Province,China;Department of Gastroenterology,Zhejiang Hospital,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]德清县人民医院普外科,浙江省湖州市313200 [2]浙江医院消化科,浙江省杭州市310000

出　　处：《世界华人消化杂志》2018年第29期1729-1734,共6页World Chinese Journal of Digestology

摘　　要：目的研究针对性营养干预对行直肠癌根治手术患者排便功能、营养指标及术后并发症的影响.方法选择2015-01/2016-12在浙江医院接受直肠癌根治术的患者130例.用随机数表法分为对照组和观察组,每组各65例,对照组行常规营养干预,观察组给予针对性营养干预.比较两组患者的排便功能、营养指标、术后恢复情况和术后并发症.结果观察组患者优23例(35.38%),良27例(41.54%),优良率为76.92%,高于对照组60.00%的优良率(P<0.05).观察组患者的术后排气时间为1.83 d±0.68 d,术后排便时间为2.81 d±1.06 d,半流质饮食恢复时间为9.84 d±1.26 d,术后住院时间为16.27 d±1.53 d,均小于对照组(P<0.05).观察组患者术后1 wk的总蛋白、白蛋白、前白蛋白、血红蛋白和转铁蛋白水平分别为68.35 g/L±13.63 g/L、36.17 g/L±5.62 g/L、0.29 g/L±0.08 g/L、124.75 g/L±28.14 g/L和1.97 g/L±0.51g/L,明显高于对照组(P <0.05).两组患者肺部感染、尿路感染、切口愈合不良和吻合口瘘的发生率相近(P>0.05),观察组患者总并发症的发生率为7.69%,低于对照组20.00%的总并发症发生率(P<0.05).结论针对性营养干预可以明显改善行根治性手术直肠癌患者的排便功能和营养指标,促进患者术后康复,降低并发症的发生率,值得在临床推广应用.AIM To investigate the effect of targeted nutrition intervention on defecation, nutritional indicators and postoperative complications in patients undergoing radical resection for rectal cancer.METHODS One hundred and thirty patients who underwent radical resection for rectal cancer at Zhejiang Hospital were selected from January 2015 to December 2016. They were randomly divided into a control group and an observation group, with 65 cases in each group. The control group underwent routine nutritional intervention, and the observation group was given targeted nutritional intervention. Defecation function, nutritional indexes, postoperative recovery and postoperative complications were compared between the two groups.RESULTS Excellent recovery of defecation function was achieved in 23（35.38%） patients and good recovery of defecation function was achieved in 27（41.54%） patients in the observation group. The rate of excellent and good recovery of defecation function was significantly higher in the observation group than in the control group（76.92% vs 60%, P〈0.05）. Time to postoperative exhaust（1.83 d ± 0.68 d vs 2.75 d ± 0.84 d）, time to postoperative defecation（2.81 d ± 1.06 d vs 3.95 d ± 1.38 d）, time to intake of semiliquid diet（9.84 d ± 1.26 d vs 11.72 d ± 1.58 d）, and postoperative hospitalization time（16.27 d ± 1.53 d vs 18.49 d ± 2.14 d） were significantly shorter in the observation group than in the control group（P〈0.05）. Serum total protein, albumin, prealbumin,hemoglobin and transferrin levels at 1 week after surgery were 68.35 g/L ± 13.63 g/L, 36.17 g/L ± 5.62 g/L, 0.29 g/L ± 0.08 g/L, 124.75 g/L ± 28.14 g/L and 1.97 g/L ± 0.51 g/L, respectively, in the observation group, which were significantly higher than those of the control group（56.32 g/L ± 10.66 g/L, 26.12 g/L ± 4.25 g/L, 0.18 g/L ± 0.04 g/L, 100.26 g/L ± 23.86 g/L and 1.56 g/L ± 0.35 g/L, respectively; P〈0.05）. The incidence of pulmonary infection, urinary tract infection, wound healing, a

关 键 词：针对性营养干预 直肠癌 排便功能 营养指标 

分 类 号：R473.73[医药卫生—护理学]