术前口服营养补充对可疑或中度营养不良胃癌患者的影响

Effect of preoperative oral nutrition supplements on patients with suspected or moderately malnourished gastric cancer

目的探讨对可疑或中度营养不良胃癌患者术前应用口服营养补充(ONS),对实施加速康复外科理念(ERAS)患者术后营养状态和临床结局的影响。方法选取某三甲医院胃肠外科收治的100例可疑或中度营养不良胃癌患者,随机分为观察组和对照组。观察组术前给予3~7 d的ONS,并进行常规饮食教育,对照组采取常规术前饮食教育。2组均按ERAS流程处理,观察2组术后营养相关指标变化,术后营养不良程度、早期活动耐受力、并发症的发生率及住院时间的影响。结果 2组术后第1天ALB、PA、RBP比较,观察组高于对照组(P<0.05);2组术后营养不良程度评分比较,对照组高于观察组(P<0.05);2组术后第1、2、4天活动耐受力评分比较,观察组早期下床活动耐受力优于对照组(P<0.05)。结论术前ONS可以改善可疑或中度营养不良胃癌患者的营养状态,提高术后早期活动耐受力,加速患者术后康复。

Objective To investigate the effect of preoperative oral nutritional supplements (ONS) on postoperative nutritional status and clinical outcome of patients with suspected or moderately malnourished gastric cancer undergoing the implementation of ERAS.Methods A total of 100 cases of suspected or moderately malnourished gastric cancer patients were randomly divided into observation group and control group.In the observation group,ONS were given 3 to 7 days before operation and routine diet education was carried out.The control group received routine preoperative dietary education.Patients in both groups were treated according to ERAS procedure,and the changes of postoperative nutrition-related indexes,postoperative malnutrition degree,early activity tolerance,incidence of complications and length of stay in the two groups were observed.Results ALB,PA and RBP on the first day after surgery in the observation group were higher than those in the control group (P<0.05).The score of postoperative malnutrition was higher in the control group than that in the observation group (P<0.05).Compared with the activity tolerance scores of the two groups on the first,second and fourth day after surgery,the activity tolerance of the observation group at the early stage of getting out of bed was better than that of the control group (P<0.05).Conclusion Preoperative ONS can improve the nutritional status of gastric cancer patients with suspected or moderate malnutrition,improve the tolerance of early postoperative activities,and accelerate postoperative recovery.