多学科协作诊治模式下营养干预在老年消化系统疾病患者围术期的应用  

Perioperative application of nutritional intervention in elderly patients with digestive system diseases under multi-disciplinary treatment(MDT)mode

作　　者：夏伊达·肖开提 姚俊英[2] 迪拉热·迪里木拉提 范旻[2] Xiayida Xiaokaiti;YAO Junying;Dilare Dilimulati;FAN Min(School of Public Health,Xinjiang Medical University,Urumqi 830017,China;Clinical Nutrition Research Institute of Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830000,China)

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830017 [2]新疆维吾尔自治区人民医院临床营养研究所,乌鲁木齐830000

出　　处：《新疆医科大学学报》2023年第9期1262-1266,共5页Journal of Xinjiang Medical University

基　　金：国家重点研发项目(2018YFC2001804)。

摘　　要：目的探讨多学科协作诊治(MDT)模式下的营养干预对老年消化系统手术患者围术期的干预效果。方法选取2021年1月-2022年1月收治于新疆维吾尔自治区人民医院微创外科的109例老年消化道手术患者为研究对象,根据患者能否接受MDT将其分为MDT组(53例)与非MDT组(56例)。比较两组患者营养、炎症相关指标水平,以及术后并发症发生情况等。结果治疗后,MDT组和非MDT组总蛋白和白蛋白水平均较治疗前升高(P<0.05),且MDT组总蛋白和白蛋白水平与非MDT组比较,差异均有统计学意义(P<0.05)。治疗后,MDT组和非MDT组白细胞计数(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)均较治疗前下降,25-羟基维生素D(25-OH-VD)水平较治疗前升高,差异均有统计学意义(P<0.05)。治疗后,MDT组WBC、25-OH-VD、CRP、IL-6、降钙素原(PCT)等炎症相关指标与非MDT组比较,差异均有统计学意义(P<0.05)。MDT组患者总住院天数、总住院费用均低于非MDT组患者,差异有统计学意义(P均<0.05)。结论MDT模式下的营养干预能有效改善老年消化系统手术患者的术后营养状态及炎症状态,缩短患者的住院时间,减少其住院费用。Objective To study the effect of nutritional intervention under multi-disciplinary treatment(MDT)mode on the perioperative intervention in elderly patients with digestive system surgery.Methods A total of 109 elderly patients underwent gastrointestinal surgery admitted to the hospital from January 2021 to January 2022 were selected as the research subjects.The patients were divided into an MDT group(53 cases)and a non MDT group(56 cases)based on their ability to accept MDT.The levels of nutrition,inflammation and postoperative complications were compared between the two groups.Results After the treatment,the total protein and albumin levels in the MDT group and non MDT group were increased compared to before the treatment(P<0.05),and the total protein and albumin levels in the MDT group were statistically significant compared to the non MDT group(P<0.05).After the treatment,the WBC,CRP and IL-6 levels in the MDT group and non MDT group were decreased compared to before the treatment,while the levels of 25-OH-VD were increased compared to before the treatment,with statistical significance(P<0.05).After the treatment,there were statistically significant differences in inflammation related indicators such as WBC,25-OH-VD,CRP,IL-6 and PCT between the MDT group and the non MDT group(P<0.05).The total hospitalization days and total hospitalization expenses of the patients in the MDT group were lower than those of the patients in the non MDT group,with statistically significant differences(P<0.05).Conclusion The nutritional intervention under MDT mode can effectively improve the nutritional status and inflammatory status in elderly patients after digestive system surgery,reduce the hospitalization time and costs of the patients.

关 键 词：MDT 营养干预 围术期 老年 

分 类 号：R575.6[医药卫生—消化系统]