腹腔镜下结直肠癌手术围手术期加强口服营养补充的临床观察

Clinical observation of oral nutrition supplement during perioperative of laparoscopic colorectal surgery

目的探讨腹腔镜下结直肠癌手术患者围手术期加强口服营养补充的临床疗效。方法选择2018年7月至2019年7月徐州市中心医院收治的拟行腹腔镜下结直肠癌手术治疗的患者的临床资料,术前按照随机数字表法分为加强口服营养补充组(ONS)及常规组各50例,比较两组患者围手术期临床指标,统计分析患者一般资料、围手术期前白蛋白及白蛋白水平、围手术期并发症情况等。结果 93例完成临床试验,其中加强口服营养补充组43例,常规组50例。术后第7天加强口服营养补充组的白蛋白(t=3.2948,P=0.0014)及前白蛋白(t=3.5386,P=0.0006)水平均高于常规组,差异有统计学意义。加强口服营养补充组与常规组首次排气排便时间比较[(49.2±10.3)h vs.(60.5±13.1)h,t=-4.5696;P<0.001],差异有统计学意义。两组患者围手术期并发症如肺部感染、切口感染、吻合口漏等并发症发生率差异均无统计学意义。加强口服营养补充组术后肠内营养耐受率为90.0%(45/50)。结论腹腔镜下结直肠癌围手术期加强口服营养补充安全有效,能改善患者营养状态,促进消化道功能的恢复。

Objective To explore the clinical effects of oral nutrition supplementation on patients with laparoscopic colorectal cancer during perioperative period.Methods Follow the random number table method,patients with laparoscopic colorectal cancer surgical treatment from Xuzhou Central Hospital from July 2018 to July 2019 were divided into 50 cases of oral nutrition supplements(ONS group)and 50 cases of routine group,and the perioperative clinical indicators of the two groups were compared.The general data of patients,the levels of albumin and prealbumin of the perioperative period,and the complications etc during the perioperative period were analyzed.Results Nighty-three cases completed clinical trials,including 43 cases of ONS group,fifty cases of normal group.Albumin(t=3.2948,P=0.0014)and prealbumin levels(t=3.5386,P=0.0006)of ONS group were higher than that of normal group on the seventh day after surgery,difference was statistically significant.The time of the first exhaust and defecation between the ONS group and the routine group[(49.2±10.3)h vs.(60.5±13.1)h,t=-4.5696;P<0.001]was statistically significant.Perioperative complications of two groups such as pulmonary infection,infection of incision,anastomotic leakage had no significant statistically differences.The tolerance rate of enteral nutrition of ONS group was 90.0%(45/50).Conclusion Oral nutrition supplementation on patients with laparoscopic colorectal cancer during perioperative period is safe and effective,which can improve the nutritional status of patients and promote the recovery of digestive tract function.