食管癌根治术后出院患者口服营养补充影响因素及对策分析

Analysis of influencing factors and countermeasures of oral nutritional supplement for patients discharged from hospital after radical esophagectomy

目的研究食管癌根治术后出院患者口服营养补充(ONS)的影响因素。方法选取2018年1月~2019年3月在我院胸外科行食管癌根治术的60例出院患者为研究对象,在常规经口进食的基础上,上、下午各进行250 kcal/次的ONS,持续1个月,通过跟踪电话回访,发现ONS实施存在的问题,并及时予以解决,观察患者出院时与出院后1个月体重、PG-SGA评分及营养相关的实验室指标对比情况。结果患者出院后1个月的各项观察指标均优于出院时,体重较出院时上升(P=0.032);PG-SGA评分较出院时降低(P=0.000);营养状态较出院时改善(P=0.000);血清总蛋白、血清白蛋白、前白蛋白以及淋巴细胞比率均高于出院时,差异有统计学意义(P<0.05)。结论在医、护、营养师及患者四方的和谐协作下,通过对食管癌根治术后出院患者ONS实施过程中存在问题进行积极有效的干预,ONS能够取得很好的效果。

Objective To study the influencing factors of oral nutritional supplement(ONS)in discharged patients after radical operation for esophageal cancer.Methods Sixty patients discharged from January 2018 to March 2019 who underwent radical esophageal cancer surgery in our thoracic surgery department were selected as the research subjects.On the basis of regular oral feeding,they were treated with 250 kcal/time of ONS in the morning and afternoon for 1 month.Through follow-up telephone calls,problems in the implementation of ONS were found and resolved in a timely manner.The comparison of the patient's body weight,PG-SGA score and nutrition-related laboratory indicators at the time of discharge and 1 month after discharge was observed.Results The observation indicators of the patients 1 month after discharge were better than those at discharge,and the body weight was higher than that at discharge(P=0.032);PG-SGA score was lower than that at discharge(P=0.000);nutritional status improved compared with that at discharge(P=0.000).Total serum protein,serum albumin,prealbumin,and lymphocyte ratios were higher than those at discharged,and the difference was statistically significant(P<0.05).Conclusion Under the harmonious cooperation of medical,nursing,dietitian and patients,ONS can achieve good results through active and effective interventions in the ONS implementation of patients discharged after radical esophageal cancer surgery.