早期肠内营养联合早期运动干预对结肠癌根治术后患者的影响

Effect of early enteral nutrition combined with early exercise intervention on patients with colon cancer after radical operation

目的探讨早期肠内营养联合早期运动干预对结肠癌根治术后患者的影响。方法选取2017年1月至2018年12月在本院治疗的130例结肠癌患者作为研究对象,根据随机数字表法分为两组,各65例。对照组于结肠癌根治术后采用常规护理和肠外营养的方式,研究组术后采用早期肠内营养联合早期运动干预的方式。比较两组研究对象的术后情况,对比两组术前、术后1 d和7 d的营养及免疫状态,采用Karnofsky评分分析预后生活质量,统计并分析两组患者的术后并发症情况。结果研究组术后排气时间、开始进食时间、住院时长分别为(1.31±0.23)h、(2.39±0.37)h、(9.38±2.03)d,均小于对照组(2.35±0.36)h、(3.91±0.42)h、(12.77±2.11)d,差异均有统计学意义(均P<0.05);两组白蛋白、前蛋白、转铁蛋白水平均表现出先降低后上升的趋势,且在不同时间点、不同组间以及术后1 d、7 d不同组间比较,差异均有统计学意义(均P<0.05);术后1 d、7 d,研究组均高于对照组,差异均有统计学意义(均P<0.05);两组CD3+T、CD4+T、CD8+T、CD34T/CD8+T、NK水平也表现出先下降后升高的趋势,且在不同时间点、不同组间以及术后1 d、7 d不同组间比较,差异均有统计学意义(均P<0.05);研究组Karnofsky评分为(80.47±3.28)分,高于对照组(68.31±2.77)分,差异有统计学意义(P<0.05);研究组术后并发症发生率为9.23%,低于对照组23.08%,差异有统计学意义(P<0.05)。结论对于结肠癌根治术后的患者采用早期肠内营养联合早期运动的干预方式,有利于改善患者的营养状态,促进免疫功能恢复,有效的改善预后生活质量。

Objective To investigate the effect of early enteral nutrition combined with early exercise intervention on patients with colon cancer after radical resection.Methods A total of 130 colon cancer patients treated at our hospital from January,2017 to December,2018 were enrolled in the study.According to the random number table,the study group and the control group were divided into a control group and a study group,with 65 cases in each group.The control group took routine nursing care and parenteral nutrition.The study group took early enteral nutrition and early exercise intervention.The postoperative statuses of the two groups were compared.The nutritional and immune statuses of the two groups were compared before and 1 and 7 days after the surgery.The Karnofsky score was used to analyze the prognosis quality of life.The postoperative complications of the two groups were analyzed.Results The postoperative exhaustion time,time to eat,and hospitalization time were shorter in the study group than in the control group[(1.31±0.23)h vs.(2.35±0.36)h,(2.39±0.37)h vs.(3.91±0.42)h,and(9.38±2.03)d vs.(12.77±2.11)d;all P<0.05].The levels of albumin,proprotein,and transferrin decreased and then increased in both groups, with statistical differences between different time pointsand groups (all P < 0.05), and were higher in the study group than in the control group 1 and 7 days after theoperation (all P < 0.05). The levels of CD3+ T, CD4+ T, CD8+ T, CD34 T/CD8+ T, and NK decreased andthen increased in both groups, with statistical differences between different time points and groups and betweenthese two groups 1 and 7 days after the operation (all P < 0.05). The Karnofsky score of the study group washigher than that of the control group [(80.47±3.28) vs. (68.31±2.77);P < 0.05]. The incidence of postoperativecomplications was lower in the study group than in the control group (9.23% vs. 23.08%;P < 0.05). ConclusionEarly enteral nutrition combined with early-onset exercise for patients with colon cancer after radical surgery isbeneficial to improve their nutritional status, recovery of immune function, and prognosis quality of life.