结直肠癌加速康复患者术后精准口服营养指导方案的构建及效果评价  

Construction andeffect evaluation of precise oral nutrition guidance program for postoperative patients with colorectal cancer undergoing accelerated rehabilitation

作　　者：王爱华[1] 张宜南[1] 智晓旭[2] 牛妞 许畅[1] 朱珠 高敬 Wang Aihua;Zhang Yinan;Zhi Xiaoxu;Niu Niu;Xu Chang;Zhu Zhu;Gao Jing(Department of Colorectal Surgery,Jiangsu Cancer Hospital,Jiangsu Cancer Prevention and Control Research Institute,Cancer Hospital Affiliated to Nanjing Medical University,Nanjing 210009,China;Nursing Department of Jiangsu Provincial Tumor Hospital,Jiangsu Institute of Cancer Prevention and Treatment,Cancer Hospital ofNanjing Medical University,Nanjing 210009,China;Department of Colorectal Surgery,Nanjing Drum Tower Hospital,Nanjing 210008,China)

机构地区：[1]江苏省肿瘤医院、江苏省肿瘤防治研究所、南京医科大学附属肿瘤医院结直肠外科,南京210009 [2]江苏省肿瘤医院、江苏省肿瘤防治研究所、南京医科大学附属肿瘤医院护理部,南京210009 [3]南京鼓楼医院结直肠外科,南京210008

出　　处：《中国实用护理杂志》2023年第17期1281-1287,共7页Chinese Journal of Practical Nursing

基　　金：国家自然科学基金(71804073);江苏省科技厅社会发展面上项目(BE2021747);江苏省肿瘤医院科研基金(ZH202006)。

摘　　要：目的构建结直肠癌加速康复患者术后精准口服营养指导方案并评价其应用效果。方法本研究为类实验研究。便利抽样法选取2021年3—12月江苏省肿瘤医院结直肠外科收治的116例择期手术的结直肠癌患者作为研究对象,按入院时间分为2组,每组58例,试验组采用结直肠癌术后精准口服营养指导方案,对照组采用常规快速康复饮食指导。比较2组术后胃肠道耐受率、口服营养补充剂依从率、术后首次排便时间及白蛋白、总蛋白、前白蛋白等营养指标。结果最终纳入分析样本111例,试验组56例,对照组55例。试验组术后口服营养补充剂依从率为73.2%(41/56),高于对照组的40.0%(22/55),2组比较差异有统计学意义(χ^(2)=12.47,P<0.05)。试验组术后首次排便时间为(29.51±5.52)h,少于对照组的(61.48±8.39)h,2组比较差异有统计学意义(t=-12.06,P<0.05)。试验组术后肠内营养耐受率为91.1%(51/56),高于对照组的69.1%(38/55),2组比较差异有统计学意义(χ^(2)=8.44,P<0.05)。试验组术后血清总蛋白、白蛋白、前白蛋白水平分别为(66.56±5.15)、(46.78±7.62)g/L和(276.07±53.57)mg/L,与同期对照组的(60.27±4.37)、(39.12±6.41)g/L和(230.14±44.58)mg/L相比,差异均有统计学意义(t=6.66、5.02、4.91,均P<0.05)。结论实施精准口服营养指导方案有利于指导结直肠癌患者术后口服营养补充剂的临床实践,提高患者依从性,降低胃肠道不耐受,促进肠道功能恢复,改善患者营养状态。Objective To construct and evaluate the effect of precise oral nutrition guidance program for colorectal cancer patients with accelerated rehabilitation after operation.Methods This study was a quasi experimental study.A total of 116 patients with colorectal cancer from department of Colorectal Surgery,Jiangsu Cancer Hospital from March to Deamber,2021 were selected by convenience sampling method.They were divided into two groups according to their admission time,the experimental group(58 cases),was given precise oral nutrition guidance program after colorectal cancer surgery based.In the control group,58 cases were treated with the conventional dietary guidance for rapid rehabilitation.The gastrointestinal tolerance rate,the compliance rate of oral nutritional supplements,the first defecation time after operation,albumin,total albumin,prealbumin and other nutritional indexes were compared between the two groups before and after intervention.Results Finally,111 cases were included,induding 56 in the experimental group and 55 in the control group.The compliance rate of oral nutritional supplements after intervention in the experimental group was 73.2%(41/56),higher than that in the control group 40.0%(22/55),and the difference between the two groups was statistically significant(χ^(2)=12.47,P<0.05).The first defecation time after operation in the experimental group was(29.51±5.52)h,while in the control group was(61.48±8.39)h,the difference between the two groups was significant(t=-12.06,P<0.05).The postoperative enteral nutrition tolerance rate of the experimental group was 91.1%(51/56),which was higher than the 69.1%(38/55)in the control group,the difference between the two groups was statistically significant(χ^(2)=8.44,P<0.05).The serum total protein,albumin and prealbumin levels of the experimental group at discharge were(66.56±5.15),(46.78±7.62)g/L and(276.07±53.57)mg/L,compared with the(60.27±4.37),(39.12±6.41)g/L and(230.14±44.58)mg/L in the control group,the differences were statistically signifi

关 键 词：结直肠肿瘤 护理 加速康复外科 口服营养补充剂 膳食营养方案 

分 类 号：R735.34[医药卫生—肿瘤]