喉癌部分喉切除术后患者的营养风险筛查及营养支持

The nutrition risk screening and nutrition support for laryngeal cancer patients after partial laryngectomy

目的利用营养风险筛查工具(NRS-2002)对喉癌部分切除术后营养情况进行评价,探讨营养支持的效果。方法采用整群抽样法选取2015年2月—2016年12月耳鼻喉科收治的首次行喉部分切除术的喉癌患者98例设为NRS指导组,进行NRS指导下的营养支持,比较其行营养支持治疗前后的营养指标,并调取2012年1月—2015年1月行初次部分喉切除术的喉癌患者在院期间临床资料进行配对,纳入98例患者,设为非NRS指导组,比较2组术后并发症情况,比较NRS指导组营养支持前后营养指标变化。结果 NRS指导组术后切口感染、术区出血、咽瘘、肺部感染发生率均低于非NRS指导组,差异有统计学意义(P<0.05),NRS指导组营养支持后总蛋白(TP)、血清白蛋白(ALB)、血红蛋白(Hb)水平均高于营养支持治疗前,差异有统计学意义(P<0.05)。结论采用NRS2002指导喉癌部分切除术后患者的营养支持,有利于提升患者的整体营养水平,降低术后并发症发生率。

Objective To evaluate the nutrient status of laryngeal cancer patients after partial laryngectomy by Nutrition Risk Screening-2002(NRS-2002),and to discuss the effect of nutrition support.Methods Totally 98 laryngeal cancer patients undergoing partial laryngectomy were selected as the NRS group.The NRS-based nutrition support plan was carried out,and levels of nutritional indexes were observed and compared before and after nutrition support.A match-pair analysis of clinical data of another 98 patients(non-NRS group)was conducted.The postoperative complication rate of two groups was compared.Results The postoperative complication rate of incision infection,hemorrhage at surgical area,pharyngeal fistula and pulmonary infection was lower in the NRS group than that of non-NRS group respectively(P<0.05).Patients of the NRS group hand higher levels of total protein,serum albumin and hemoglobin after nutrition support(P<0.05).Conclusion The NRS-based nutrition support plan is advantaged to improve the nutrient status of laryngeal cancer patients and reduce the risk of complications after partial laryngectomy.