直肠癌老年患者术前不同营养状态对术后康复影响的研究

Effect of different nutritional status of elderly patients with rectal cancer before surgery on postoperative rehabilitation

目的探讨直肠癌切除术老年患者术前不同营养状态对患者手术后恢复的影响,为合理的营养支持及改善预后提供帮助。方法选取我院肿瘤科直肠癌老年患者（年龄64~70岁）100例,使用营养风险筛查法NRS2002进行手术前营养风险筛查。将评分为1~2分的患者作为A组;评分不低于3分的患者作为B组;比较2组患者中接受和未接受肠内营养支持患者各项指标恢复情况。结果经NRS2002量表评定,76例患者存在营养风险,其中37例进行了营养支持,其各项恢复情况明显优于无营养支持的营养风险性患者,术后胃管拔出时间[（1.8±0.4）d vs.（2.9±1.5）d]、排气时间[（2.4±0.6）d vs.（4.3±0.9）d]、进食时间[（2.9±0.5）d vs.（4.5±1.1）d]、住院时间[（10.8±0.9）d vs.（14.1±1.3）d]、感染相关性并发症发生率（0 vs.5.13%）,差异均具有统计学意义（P〈0.05）。结论直肠癌老年患者手术前进行营养风险程度评估,针对性营养支持可显著改善患者术后营养情况并促进术后胃肠功能进行恢复。

Objective To summarize the prognosis of elderly patients with colorectal cancer excision who were divided into different groups by the nutritional status before their surgery. Methods In our hospital,100 patients（ age from 64 to 70） with colorectal cancer were performed the screening of nutritional risk by NRS2002 before surgery. Patients with score from 1 to 2 were as the group A,and patients with score over 3 were as group B. The related indexes and recovery between two groups were compared. Results The NRS2002 rating scale score showed that 76 patients were at nutritional risk,37 cases among them received nutrition support and had faster recovery of intestinal function the time of tube pulled out after operation[（1. 8 ± 0. 4） d vs.（2. 9 ± 1. 5） d],exhaust time[（2. 4 ± 0. 6） d vs.（4. 3 ± 0. 9） d],time of intake food[（2. 9 ± 0. 5） d vs.（4. 5 ± 1. 1） d],length of stay[（10. 8 ± 0. 9） d vs.（14. 1 ± 1. 3） d],incidence of infection related complications（0 vs. 5. 13%）,the differences were statistically significant（ P 0. 05）. Conclusion Problems exist in varying degrees of loss of nutrition in elderly colorectal cancer patients before surgery,an objective assessment of the extent and targeted care and nutritional support can significantly improve the postoperative nutrition and to facilitate recovery of gastrointestinal function after surgery.