加速康复理念下的个体化营养支持在胃部分切除术患者术后康复的临床应用  

Clinical Application of Individualized Nutritional Support Under the Concept of Accelerated Recovery in Postoperative Rehabilitation of Gastric Partial Resection Patients

作　　者：刘明亮 LIU Mingliang(Department of Surgery,Xun County People's Hospital,Hebi Henan 456250,China)

机构地区：[1]浚县人民医院外科,河南鹤壁456250

出　　处：《临床研究》2025年第1期44-47,共4页Clinical Research

摘　　要：目的探究外科胃部分切除手术患者应用加速康复理念下的个体化营养支持对其术后康复的影响。方法选择浚县人民医院外科2021年1月到2024年9月期间收治的92例接受胃部分切除的胃癌患者,根据其营养支持方案分为常规组(47例,常规术后营养支持方案)和康复组(45例,加速康复理念下的个体化营养支持)。对比两组术前以及术后3个月胃肠功能(胃排空率、胃体蠕动次数)、营养状况(身体营养指标和血液营养指标)及免疫指标(T淋巴细胞亚群)变化,统计对比两组患者术后并发症的发生率差异。结果术前,两组胃排空率及胃体蠕动次数比较,差异无统计学意义(P>0.05)。术后3个月,两组胃排空率及胃体蠕动次数均高于术前,且康复组高于常规组,差异具有统计学意义(P<0.05)。术前,两组体质量指数(BMI)、握力(GS)、三头肌皮褶厚度(TSF)、白蛋白(ALB)、前白蛋白(PAB)及转铁蛋白(TRF)水平比较,差异无统计学意义(P>0.05)。术后3个月,康复组BMI及两组患者的GS、TSF、ALB、PAB及TRF水平均高于术前,且康复组BMI、ALB、PAB及TRF高于常规组,差异均有统计学意义(P<0.05)。术前,两组CD3^(+)T、CD4^(+)T及CD4^(+)T/CD8^(+)T比较,差异无统计学意义(P>0.05)。术后3个月,康复组CD4^(+)T/CD8^(+)T及两组CD3^(+)T、CD4^(+)T水平均高于术前,且康复组高于常规组,差异有统计学意义(P<0.05)。常规组患者术后出现并发症11例(23.40%),康复组术后出现并发症2例(4.44%),康复组患者术后并发症发生率低于常规组,差异具有统计学意义(χ^(2)=6.811,P<0.05)。结论应用加速康复理念下的个体化营养支持方案有助于促使胃部分切除手术患者胃肠功能的恢复,改善其术后营养状况和免疫状况,降低术后并发症发生率,应用效果理想。Objective To investigate the impact of individualized nutritional support based on the concept of accelerated recovery on postoperative rehabilitation in patients undergoing surgical gastric partial resection.Methods A total of 92 patients with gastric cancer who underwent gastric partial resection at Xun County People's Hospital from January 2021 to September 2024 were selected.According to their nutritional support plans,patients were divided into a conventional group(47 cases receiving the standard postoperative nutritional support plan)and a rehabilitation group(45 cases receiving individualized nutritional support under the accelerated recovery concept).The two groups were compared regarding gastrointestinal function(gastric emptying rate,gastric body motility),nutritional status(body nutritional indicators and blood nutritional indicators),and immune indicators(T lymphocyte subgroups)three months post-surgery.The incidence of postoperative complications between the two groups was also compared.Results Before surgery,there were no statistically significant differences in gastric emptying rate or gastric body motility between the two groups(P>0.05).Three months post-surgery,both groups showed increased gastric emptying rates and gastric body motility compared to pre-surgery levels,with the rehabilitation group demonstrating significantly higher rates than the conventional group(P<0.05).Pre-surgery,there were no statistically significant differences in body mass index(BMI),grip strength(GS),triceps skinfold thickness(TSF),albumin(ALB),prealbumin(PAB),or transferrin(TRF)levels between the groups(P>0.05).Three months post-surgery,the rehabilitation group showed higher scores in BMI,GS,TSF,ALB,PAB,and TRF than pre-surgery levels,with significantly higher BMI,ALB,PAB,and TRF in the rehabilitation group compared to the conventional group(P<0.05).Pre-surgery,there were no statistically significant differences in CD3^(+)T,CD4^(+)T,or CD4^(+)/CD8^(+)T ratios between the two groups(P>0.05).Three months post-surgery,the

关 键 词：胃部分切除术 加速康复理念 个体化营养支持 营养状况 免疫 

分 类 号：R656.6[医药卫生—外科学]