摘要
目的 本研究旨在探讨老年胃癌患者围术期肠内肠外营养护理方法的临床效果。方法 选取2023年1月至2024年9月期间，在我院接受胃癌手术治疗的老年患者80例，随机分为观察组和对照组，每组40例。观察组采用肠内肠外联合营养支持方式，对照组则采用单纯肠外营养支持。收集两组患者的营养指标（白蛋白水平、前白蛋白水平、淋巴细胞计数）、胃肠功能恢复指标（首次排气时间、首次排便时间、肠鸣音恢复时间）及并发症发生率数据，并进行统计学分析。结果 干预后，观察组患者的白蛋白水平、前白蛋白水平及淋巴细胞计数均高于对照组（P＜0.05）；观察组患者的首次排气时间、首次排便时间及肠鸣音恢复时间均短于对照组（P＜0.05）。此外，观察组患者的并发症发生率低于对照组（P＜0.05）。结论 老年胃癌患者围术期采用肠内肠外联合营养支持方式，能显著改善患者的营养状况，促进胃肠功能恢复，并降低并发症发生率，具有较高的临床应用价值。
关键词： 老年胃癌；围术期；肠内肠外营养；营养状况；胃肠功能；并发症
Abstract
Objective This study aims to investigate the clinical effects of perioperative enteral parenteral nutrition in elderly patients with gastric cancer. Methods 80 elderly patients undergoing surgery for gastric cancer in our hospital from January 2023 to September 2024 were selected and randomly divided into observation group and control group, with 40 patients in each group. The observation group used inenteral parenteral combined nutrition support, while simple parenteral nutrition support was used in the control group. Data on nutritional indicators (albumin level, prealbumin level, lymphocyte count), gastrointestinal function recovery time (first exhaust time, first defecation time, bowel song recovery time) and complication rate were collected in both groups for statistical analysis. Results After the intervention, the albumin level, prealbumin level and lymphocyte count in the observation group were higher than those in the control group (P <0.05); the time of first discharge, first defecation and bowel sounds were shorter than those in the control group (P <0.05). In addition, the complication rate was lower in the observation group than in the control group (P <0.05). Conclusion The perioperative enteral and parenteral combined nutritional support for elderly gastric cancer patients can significantly improve the nutritional status, promote the recovery of gastrointestinal function, and reduce the incidence of complications, which has a high clinical application value.
Key words： Elderly gastric cancer; Perioperative; Parenteral nutrition; Nutritional status; Gastrointestinal function; Complications
参考文献 References
[1] 汪巧月.营养支持护理和心理护理改善胃癌患者生活质量的效果评价[J].智慧健康,2022,8(27):182-185.
[2] 何碧莲,陈祥莺,林丽春,苏密龙.早期肠内营养在肝胆外科术后患者胃肠功能恢复中的价值[J].中国卫生标准管理,2021,12(6):51-53.
[3] 肖霞,李中福,郭轶,高云瀚,胡淞.经鼻-空肠肠内营养对胃癌根治术后患者营养状况、炎症反应及并发症的影响[J].贵州医科大学学报,2021,46(10):1226-1230.
[4] 姚瑶,汪洁,赵海峰,谢浩芬,徐琴鸿,蔡泽君,严志龙,黄晓燕.胃癌术后患者早期肠内营养支持的最佳证据总结[J].中华现代护理杂志,2022,28(14):1869-1875.
[5] 范严君,王建新,裴永菊,申丽香.早期营养支持护理干预对食管癌手术患者术后营养状况、免疫功能及胃肠功能恢复的影响[J].国际护理学杂志,2022,41(15):2810-2813.
[6] 罗东明,钟倩,陈德伦,诸葛冬桂,邹世镇,汪志华.早期肠内营养支持对胃癌术后患者肠黏膜屏障功能保护的研究进展[J].中华普外科手术学杂志（电子版）,2022,16(6): 700-702.
[7] 陈琛,王敏.早期营养护理对胃癌术后患者免疫功能、营养指标的影响[J].临床医学研究与实践,2023,8(10):125-127.
[8] 郝会芬,李晶晶,赵盼盼.早期肠内营养联合肠外营养在胃癌术后患者中的应用[J].临床医学,2023,43(8):77-79.
[9] 程婷婷,刘丽丽,于淑媛,周丹.变革理论下护理对胃癌切除术后早期肠内营养支持患者营养指数及预后的影响[J].中国医药导报,2024,21(17):158-160.