术后早期营养支持情况对根治性膀胱全切术患者预后指标的影响  

Effect of early postoperative nutritional intervention on prognostic indicators of patients undergoing radical cystectomy

作　　者：张翅 李晓玲[1] 何其英 刘爽 汤亚箐 ZHANG Chi;LI Xiaoling;HE Qiying;LIU Shuang;TANG Yaqing(West China School of Nursing,Sichuan University&Department of Urology,West China Hospital,Sichuan University,Chengdu 610041,Sichuang,China)

机构地区：[1]四川大学华西护理学院/四川大学华西医院泌尿外科,四川成都610041

出　　处：《护士进修杂志》2023年第4期289-292,341,共5页Journal of Nurses Training

基　　金：四川省科技厅重点研发科研课题(编号:2020YFS0158)。

摘　　要：目的探讨根治性膀胱全切术患者术后早期营养支持情况对其预后指标的影响。方法收集2020年12月-2021年12月我院泌尿外科确诊为膀胱癌行根治性全膀胱切除术的患者资料进行回顾性分析,根据患者术后至肛门排气期间每日能量摄入量是否≥70%目标摄入量分为A组(n=25)与B组(n=35)。(1)比较2组患者术后营养支持情况。(2)比较2组患者在入院时、术后第1天及术后第7天生化指标的变化。结果(1)2组患者术后每日蛋白质摄入、脂肪摄入、碳水摄入及营养干预天数差异有统计学意义(P<0.05),人血白蛋白及7 d内人血白蛋白输入总剂量差异无统计学意义(P>0.05)。(2)患者生化指标组内比较:A组患者在入院时、术后第1天及第7天血清白蛋白(HGB)、红细胞(RBC)、血红蛋白(ALB)呈先下降后上升趋势,术后第1天与第7天较入院时比较差异均有统计学意义(P<0.001);白球比例(A/G)呈先下降后上升趋势,术后第1天白球比例较入院时差异有统计学意义(P<0.001),术后第7天较入院时差异无统计学意义(P>0.05)。B组患者在入院时、术后第1天及第7天时HGB、RBC、ALB均呈先下降后上升趋势,术后第1天与第7天较入院时比较差异均有统计学意义(P<0.001);A/G呈直线下降趋势,术后第1天与第7天较入院时比较差异均有统计学意义(P<0.05)。(3)患者生化指标组间比较:术后第7天,A组患者ALB和A/G均高于B组,差异均有统计学意义(P<0.05)。结论根治性膀胱全切术患者术后早期摄入足够热量有利于改善患者预后指标。临床上应针对此类患者积极开展个体化营养支持,促进患者早日康复。Objective To explore the effect of early postoperative nutritional intervention on prognostic indicators of patients undergoing radical cystectomy.Methods The data of patients diagnosed with bladder cancer who underwent radical cystectomy in the urological surgery department of our hospital from December 2020 to December 2021 were collected for retrospective analysis.The patients were divided into Group A(n=25)and Group B(n=35)according to whether their daily energy intake was≥70%of the target intake during the period from postoperative to anal exhaust.(1)The postoperative nutritional support was compared between the two groups;(2)The changes of biochemical indexes were compared between the two groups at admission,on the 1stday and the 7thday after surgery.Results(1)There were significant differences in protein intake,fat intake,carbohydrate intake,and nutritional intervention days between the two groups(P<0.05).There was no significant difference in human albumin and total dose of human albumin within 7 days(P>0.05).(2)Comparison of patients’biochemical indexes within group:Serum albumin(HGB),erythrocyte(RBC),and hemoglobin(ALB)of patients in Group A decreased at first and then increased at admission,on the 1stand the 7thday after operation,the differences of these indexes compared the 1stand 7thday after operation to at admission were statistically significant(P<0.001);The ratio of white ball(A/G)decreased at first and then increased,and this ration on the 1stday after operation was significantly different from that at admission(P<0.001),and there was no significant difference on the 7thday after operation compared with that at admission(P>0.05).HGB,RBC,and ALB decreased at first and then increased at admission,on the 1stand the 7thday after operation in Group B,and there were statistically significant differences between the 1stand the 7thday after surgery compared with the time of admission(P<0.001);A/G showed a straight-line downward trend on the 1stand the 7thday after operation compared with the admiss

关 键 词：膀胱癌 根治性膀胱全切术 热量摄入 营养支持 预后指标 

分 类 号：R473.73[医药卫生—护理学]