食管癌患者术后营养不良状况与认知行为依从干预分析

Analysis of malnutrition and cognitive behavior compliance in patients with esophageal cancer after operation

目的:调查食管癌患者术后营养不良状况,探讨认知行为依从干预对营养不良状况的影响。方法:2013年5月至2016年7月在我院诊治的食管癌术后患者120例作为研究对象,根据随机抽签原则分为观察组与对照组各60例,对照组在术后给予常规饮食干预,观察组在对照组护理的基础上给予基于认知行为依从干预的个性化饮食干预方案,护理观察时间为14d。结果:护理前观察组与对照组的营养不良发生率分别为56.7%和58.3%,护理后分别为6.7%和23.3%,观察组护理后的营养不良发生率明显少于对照组(P<0.05)。护理期间观察组的均衡饮食评分为2.48±0.42,明显高于对照组的1.75±0.44(t=9.296,P<0.05)。护理后观察组与对照组的认知功能评分分别为7.43±2.14和5.89±1.34,都明显高于护理前的3.56±1.33和3.48±1.28(P<0.05);在认知功能评分方面,护理后观察组显著高于对照组(P<0.05)。护理后观察组与对照组的血清白蛋白与前白蛋白水平都明显高于护理前(P<0.05),同时护理后观察组的血清白蛋白与前白蛋白水平明显高于对照组(P<0.05)。结论:食管癌术后患者营养不良状况比较常见,认知行为依从干预能缓解营养不良状况,提高饮食依从性,从而改善认知行为能力,促进机体营养状况。

Objective： To investigate the nutritional status of patients with esophageal cancer after operation, and explore the effects of cognitive behavior intervention on malnutrition. Methods From May 2013 to July 2016, 120 postoperative esophageal cancer patients in our hospital were selected as the research object, all the patients were equally divided into the observation group and control group of 60 patients accorded to the principles. The control group was given routine diet intervention, the observation group was added given individualized diet intervention based on cognitive behavioral compliance intervention, the nursing observation times were 14 d. Results： The incidence of malnutrition in the observation group and the control group before nursing were 56.7% and 58.3%, respectively, and the incidence of malnutrition in the observation group and the control group after nursing were 6.7% and 23.3% that the observation group was significantly less than that of the control group （P〈0.05）. During the nursing period, the scores of the balanced diet of the observation group was 2.48±0.42, which was significantly higher than that of the control group of 1.75±0.44 （t=9.296, P〈0.05）. After nursing, the cognitive function scores in the observation group and the control group were 7.43＋2.14 and 5.89±1.34 that were significantly higher than those before nursing of 3.56±1.33 and 3.48±1.28 （P〈0.05）, and the observation group was significantly higher than that of the control group （P〈0.05）. After treatment, the serum albumin and prealbumin levels in the observation group and the control group after nursing were significantly higher than those before nursing （P〈0.05）, while the serum albumin and prealbumin levels in the observation group were significantly higher than those in the control group （P〈0.05）. Conclusion： The malnutrition in the esophageal cancer after operation is common, cognitive behavior compliance intervention can alleviate malnutrition, improve dietary compliance, so as to improve the cognitive ability and promote the nutritional status.