不同营养治疗方式在妇科肿瘤围术期患者中的临床应用与分析

Clinical application and analysis of different nutritional intervention in gynecologic tumor patients during perioperative period

目的探讨不同营养治疗方式在妇科肿瘤围术期患者中的临床应用。方法选取我院2017年1月至2017年7月期间收治的90例妇科肿瘤患者作为研究对象,所有患者均行对症手术治疗。将之按照营养治疗方式不同分为观察组(n=45)和对照组(n=45),其中对照组常规术前禁食、禁水,术后6小时进食的方式进行营养治疗,观察组患者则于术前4天开始予以患者营养治疗。分别对两组患者入院时、术后7天后和术后14天后营养状况主观评价分级指标和客观营养状况指标(包括淋巴细胞计数、白蛋白、转铁蛋白、前白蛋白、血红蛋白)进行合理评估,同时比较两组患者的术后恢复相关指标和随访6个月的生活质量。结果入院时,两组患者的SGA量表和客观营养状况指标比较无统计学差异(P> 0.05),术后7天时和14天时,两组患者的SGA量表指标和客观营养指标明显优于入院时,其中以观察组术后14天时的SGA量表和客观营养状况指标最优,差异显著(P <0.05);经比较,观察组患者的肠蠕动恢复时间、排气时间及体重差等相关指标明显优于对照组,差异显著(P <0.05);另外,对两组患者随访6个月发现,观察组患者的短期生活质量评分明显优于对照组(P <0.05)。结论早期营养治疗在妇科肿瘤围术期患者中发挥了重要的作用,其不仅可以有效改善患者营养状况,且在一定的程度上提高了患者的生活质量,值得推广。

Objective To investigate the clinical application of nutritional intervention in gynecologic tumor patients during perioperative period.Methods 90 patients with gynecologic cancer treated in our hospital from January 2017 to July 2017 were selected as the object of study.All patients were treated with symptomatic surgery.Be in accordance with the nutritional intervention time and method,the patients were divided into observation group(n=45)and control group(n=45),the control group received the way of routine preoperative fasting and nutritional support 6h after,patients in the observation group received the way of nutrition support form the preoperative 4 days.Two groups of patients respectively on admission,7 days after operation and 14 days after operation after admission of the nutritional status of SGA scale(subjective global assessment)and objective indicators of nutritional status(including number of lymphocytes,albumin,transferrin,prealbumin,hemoglobin)for a reasonable evaluation and indicators related to the operation and follow-up were compared between the two groups of 6 the quality of life(SF-36).Results At the time of admission,no significant differences between the two groups of patients with SGA scale and objective nutritional status index(P>0.05),7 days after operation and 14 days after operation,the two groups of patients with normal nutrition,mild malnutrition and moderate malnutrition SGA scale index and objective nutritional index was significantly better than that of admission,the observation of SGA scale group 14 days after operation and objective nutritional status index of optimal difference(P<0.05);by comparison,the observation group of patients with intestinal peristalsis recovery time,exhaust time and weight related indicators significantly better than the control group,the difference was significant(P<0.05);in addition,found in two groups of patients were followed up for 6 months to observe.The short-term quality of life group patients were significantly better than the control group(P<0.05).Conclusions Early nutritional nursing intervention in the perioperative period in patients with gynecological tumors play an important role,which can not only improve effectively the nutritional status of patients,and to a certain extent,but also can improve the quality of life of patients.