早期肠内营养对经口寰枢椎术后患者营养状况、并发症及卫生经济学指标的影响

Effects of early enteral nutrition on patients'nutritional status,complications and health-economic indicators after transoral atlantoaxial surgery

目的探讨早期肠内营养(EEN)对经口寰枢椎复位钢板(TARP)内固定术后患者营养状况、并发症及卫生经济学指标的影响。方法回顾性分析2013年1月至2019年12月南部战区总医院采用TARP手术治疗的258例患者的临床资料,根据术后实施肠内营养治疗的不同时机,将患者分为EEN组和延迟肠内营养(DEN)组,其中EEN组130例,DEN组128例。比较2组患者在术后血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)、前白蛋白(PA)水平,切口感染、医院获得性肺炎、胸腔积液发生率以及监护病房滞留时间、住院时间、住院费用等方面的差异。结果EEN组术后血清TP、ALB、Hb、PA水平均高于DEN组,医院获得性肺炎、切口感染、胸腔积液发生率以及监护病房滞留时间、住院时间及住院费用均低于DEN组(P<0.05)。结论EEN治疗可改善TARP内固定手术患者的营养状况,降低并发症发生率,缩短监护病房滞留时间和住院时间,节省住院费用。

Objective To investigate the effects of early enteral nutrition(EEN)on patients'nutritional status,complications and health-economic indicators after transoral atlantoaxial reduction plate(TARP)internal fixation.Methods A retrospective analysis was conducted on clinical data from 258 patients who underwent TARP surgery in General Hospital of Southern Theatre Command from January 2013 to December 2019.Patients were divided into EEN group(n=130)and delayed enteral nutrition(DEN)group(n=128)according to different timing of postoperative enteral nutrition therapy.Differences of levels of postoperative serum total protein(TP),albumin(ALB),hemoglobin(Hb)and prealbumin(PA),incidences of surgical site infection,nosocomial pneumonia and pleural effusion,as well as residence time in intensive care unit,duration of stay and hospitalization costs were compared between two groups.Results Postoperative TP,ALB,Hb and PA in EEN group were higher than those in DEN group,showing statistical differences between two groups(P<0.05).Incidence of nosocomial pneumonia,incision infection and pleural effusion,as well as residence time in intensive care unit,length of stay and hospitalization costs in EEN group were lower than those in DEN group(P<0.05).Conclusion EEN for patients who underwent TARP surgery can improve their nutritional status,reduce incidence of complications,shorten residence time in intensive care unit and length of stay,as well as save the hospitalization costs.