基于以目标能量为导向的口服营养支持模式对克罗恩病术后患者营养管理的效果研究  

Effects of targeted energy-based oral nutritional support model on nutritional management of Crohn′s disease patients after surgery

作　　者：黄美娟[1] 陈春红[1] 张勤 刘文静 纪秋露 何慧娴 Huang Meijuan;Chen Chunhong;Zhang Qin;Liu Wenjing;Ji Qiulu;He Huixian(Department of Gastroenterology,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;Department of Gastroenterology,Sanming Hospital,Fujian Medical University,Sanming 365000,China)

机构地区：[1]中山大学附属第一医院消化内科一区,广州510080 [2]福建医科大学附属三明医院消化内科,三明365000

出　　处：《中华炎性肠病杂志（中英文）》2023年第4期319-323,共5页Chinese Journal of Inflammatory Bowel Diseases

摘　　要：目的探讨基于以目标能量为导向的口服营养支持模式用于克罗恩病(CD)术后患者营养管理的效果。方法回顾性纳入中山大学附属第一医院消化内科2020年1月至2020年12月行腹腔镜回肠、结肠部分切除,符合快速康复外科(ERAS)术后饮食管理的CD患者作为常规饮食管理组;2021年1月至2021年12月行腹腔镜回肠、结肠部分切除的CD患者作为梯度饮食管理组。比较两组患者术后第4天肠内营养耐受性、术后第4周体质指数(BMI)和血清白蛋白,以及术后第1、4周前白蛋白值和术后住院时间。结果纳入61例CD患者,常规饮食管理组31例,梯度饮食管理组30例。梯度饮食管理组患者术后第4天肠内营养耐受性、第4周BMI、白蛋白值、第1周及第4周前白蛋白值均优于常规饮食管理组,差异均有统计学意义(P<0.01)。梯度饮食管理组术后住院时间短于常规饮食管理组,差异有统计学意义(P<0.05)。结论CD术后以目标能量为导向的口服营养支持模式较ERAS术后饮食管理模式肠内营养耐受性更好,营养状况改善更明显,其饮食指导更具体、可操作性强,可缩短CD术后患者住院时间,值得临床推广。Objective To investigate the effectiveness of target energy-based oral nutritional support in the nutritional management of postoperative Crohn′s disease(CD)patients.Methods A retrospective analysis was conducted.CD patients who underwent laparoscopic ileocecal and colonic resection and were managed with a conventional diet at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to December 2020 were defined as conventional diet group.Another group of CD patients who underwent the same surgery from January 2021 to December 2021 and were managed with a target energy-based oral nutrition support model were defined as gradient diet group.The intestinal nutritional tolerance on the 4th day after surgery,body mass index(BMI)and serum albumin levels at 4 weeks after surgery,as well as prealbumin levels at 1st and 4th weeks after surgery,and length of hospital stay were compared between the two groups.Results A total of 61 CD patients were included,with 31 in the conventional diet group and 30 in the gradient diet group.The gradient diet group showed significantly better intestinal nutritional tolerance,BMI,albumin levels at 4th weeks after surgery,as well as prealbumin levels at 1st and 4th weeks after surgery compared to the conventional diet group,with all differences being statistically significant(P<0.01).The gradient diet group also had a significantly shorter length of hospital stay compared to the conventional diet group,with a statistically significant difference(P<0.05).Conclusions The target energy-based oral nutrition support model for CD patients after surgery demonstrats better intestinal nutritional tolerance,more pronounced improvement in nutritional status,and more specific and feasible dietary guidance compared to the conventional diet management model.It also results in a shorter length of hospital stay for CD patients after surgery,suggesting its potential for clinical application and promotion.

关 键 词：口服营养支持 梯度饮食管理 目标能量导向 术后 肠内营养耐受性 

分 类 号：R656[医药卫生—外科学]