预见性干预联合肠内营养在胆管癌术后患者中的应用效果  

Application effect of predictive intervention combined enteral nutrition in patients after cholangiocarcinoma surgery

作　　者：岳咏梅[1] 范静雯 李宁宁 崔胤 左素霞 曲小娟 YUE Yongmei;FAN Jingwen;LI Ningning;CUI Yin;ZUO Suxia;QU Xiaojuan(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China;Department of Emergency,the Third Affiliated Hospital of Zhengzhou University/He’nan Maternal and Child Health Hospital,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学第一附属医院肝胆外科,郑州450000 [2]郑州大学第三附属医院/河南省妇幼保健院急诊科,郑州4500000

出　　处：《癌症进展》2022年第21期2222-2225,共4页Oncology Progress

摘　　要：目的探讨预见性干预联合肠内营养在胆管癌术后患者中的应用效果。方法根据干预方式的不同将70例胆管癌术后患者分为对照组(n=35)和观察组(n=35),对照组患者采取常规干预联合肠内营养,观察组患者采取预见性干预联合肠内营养。比较两组患者的胃肠功能、营养状态[血红蛋白(Hb)、血清清蛋白(ALB)、血清总蛋白(TP)]、心理状态[抑郁自评量表(SDS)和焦虑自评量表(SAS)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及满意度。结果观察组患者的首次排气时间、首次自主排便时间、肠鸣音恢复时间均明显短于对照组(P﹤0.01)。术后7天,观察组患者的Hb、ALB、TP水平均明显高于对照组(P﹤0.01)。干预后,两组患者的SDS、SAS评分均低于本组干预前,且观察组患者的SDS、SAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者躯体功能、情绪功能、社会功能、认知功能、角色功能评分均高于本组干预前,且观察组患者躯体功能、情绪功能、社会功能、认知功能、角色功能评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的满意度为94.29%,高于对照组患者的74.29%,差异有统计学意义(P﹤0.05)。结论预见性干预联合肠内营养应用于胆管癌术后患者,能够改善患者的营养状态及胃肠功能,缓解患者焦虑、抑郁等不良情绪,提高患者的生活质量和满意度。Objective To investigate the application effect of predictive intervention combined enteral nutrition in patients after cholangiocarcinoma surgery.Method A total of 70 patients after cholangiocarcinoma surgery were divided into control group(n=35,received conventional intervention+enteral nutrition)and observation group(n=35,received predicative intervention+enteral nutrition)according to intervention methods.The gastrointestinal function,nutritional status[hemoglobin(Hb),albumin(ALB),total protein(TP)],psychological status[self-rating depression scale(SDS)and self-rating anxiety scale(SAS)],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnare-core 30(EORTC QLQ-C30)]and satisfaction were compared between the two groups.Result The first exhaust time,first spontaneous defecation time and bowel sound recovery time in observation group were shorter than those in control group(P<0.01).Seven days after surgery,the Hb,ALB and TP levels in observation group were higher than those in control group(P<0.01).After intervention,the SDS and SAS scores of the two groups were lower than those before intervention,with lower scores in the observation group than those in the control group,and the differences were statistically significant(P<0.05).After intervention,the scores of physical function,emotional function,social function,cognitive function and role function were higher than those before intervention,with higher scores in the observation group than those in the control group,and the differences were statistically significant(P<0.05).The satisfaction rate of the observation group was higher than that of the control group(94.29%vs 74.29%,P<0.05).Conclusion Predictive intervention combined enteral nutrition in patients with cholangiocarcinoma after surgery can improve the nutritional status and gastrointestinal function of patients,relieve anxiety and depression emotions,and improve the quality of life and satisfaction of patients.

关 键 词：胆管癌 胃肠功能 肠内营养 预见性干预 

分 类 号：R735.8[医药卫生—肿瘤]