多学科围术期全程营养管理对食管癌患者营养状态和术后并发症影响的随机对照试验

Effects of multidisciplinary perioperative nutrition management on nutritional status and postoperative complications in patients with esophageal cancer: A randomized controlled trial

目的观察多学科围术期全程营养管理对食管癌患者营养状态和术后并发症的影响。方法选择2019年2月至2020年2月四川大学华西医院胸外科确诊并行择期手术治疗的食管癌患者239例为研究对象,将其随机分为试验组(120例)和对照组(119例),其中试验组男97例、女23例,平均年龄(63.78±9.13)岁;对照组男94例、女25例,平均年龄(64.12±7.91)岁。对照组患者接受常规围术期饮食管理,试验组患者接受多学科围术期全程营养管理,比较两组患者营养状况和术后并发症的差异。结果试验组术后第3 d和第7 d的总蛋白和白蛋白水平高于对照组患者(P<0.05),术后肛门排气时间短于对照组患者(P<0.05),术后胃肠道不良反应、肺部感染、吻合口瘘、术后第3 d和第7 d的低蛋白血症发生率均低于对照组患者(P<0.05),试验组患者住院总费用少于对照组患者(P<0.05)。结论多学科全程营养管理能有效改善患者营养状态、促进术后胃肠功能快速恢复、减少术后并发症、降低住院费用,具备较高的临床参考和推广价值。

Objective To investige the effects of multidisciplinary perioperative nutrition management on nutrition and postoperative complications of patients with esophageal cancer. Methods A total of 239 patients with esophageal cancer who received elective surgical treatment were included in the study. They were divided into a trial group(120 patients) and a control group(119 patients) according to the random number table method. There were 97 males and 23 females in the trial group with an average age of 63.78±9.13 years, and 94 males and 25 females in the control group with an average age of 64.12±7.91 years. The control group received routine diet management, and the trial group received multidisciplinary perioperative nutrition management. The differences of nutrition and postoperative complications between the two groups were compared. Results The total protein and albumin levels on postoperative days 3 and 7 in the trial group were higher than those in the control group(P<0.05), patients’ postoperative anal exhaust time was shorter than that in the control group(P<0.05), the incidence of postoperative gastrointestinal adverse reactions, lung infection, postoperative anastomotic fistula, hypoproteinemia on postoperative days 3 and 7 was lower than that in the control group(P<0.05), and hospitalization cost was lower than that in the control group(P<0.05).Conclusion Multidisciplinary nutrition management can effectively improve the nutrition of patients, promote the rapid recovery of postoperative gastrointestinal function, reduce postoperative complications, and reduce hospitalization costs.It has high clinical reference and promotion value.