肝癌合并糖尿病患者行ERAS理念下运动-营养管理对血糖、术后恢复的效果

Effect of Blood Glucose and Postoperative Recovery of Patients with Liver Cancer and Diabetes under the Concept of ERAS Exercise-nutrition Management

目的研究肝癌合并糖尿病患者行ERAS理念下运动-营养管理对血糖、术后恢复的效果。方法选取该院2017年1月-2020年3月入院的肝癌合并糖尿病患者70例,均接受手术治疗,将病案号为单数的35例患者纳入对照组,双号的35例患者纳入观察组,分别采用常规护理、ERAS理念下运动-营养管理为患者提供手术的护理工作,对比两组术后恢复效果、血糖控制质量、营养情况、并发症发生率。结果对两组术后恢复效果对比,观察组排气时间(43.21±3.16)h、下床时间(2.11±1.12)d、住院时间(13.24±2.14)d少于对照组,差异有统计学意义(P<0.05)。对两组血糖指标进行对比,观察组FBG(6.23±1.14)mmol/L、PBG(9.32±1.45)mmol/L以及HbA1c(6.12±1.10)%均低于对照组,差异有统计学意义(P<0.05)。对两组营养情况进行对比,观察组ALB(38.21±3.28)g/L、DPI(1.39±0.18)g/(kg·d)、nPCR(1.34±0.29)g/(kg·d)高于对照组,差异有统计学意义(P<0.05)。对两组并发症发生率进行对比,观察组5.71%显著低于对照组22.86%,差异有统计学意义(P<0.05)。结论ERAS理念下运动-营养管理在肝癌合并糖尿病术后开展可以有效缩短术后的恢复时间,更好的对血糖进行控制,维持机体各项营养指标的均衡,控制术后各项并发症的出现,以实现疾病更加科学的治疗和恢复。

Objective To study the effect of exercise nutrition management on blood glucose and postoperative recovery of patients with hepatocarcinoma and diabetes mellitus.Methods A total of 70 patients with liver cancer complicated with diabetes admitted to the hospital from January 2017 to March 2020 were selected,and all of them received surgical treatment.35 patients with odd medical record numbers were included in the control group,and 35 patients with double numbers were included in the observation group.Routine nursing and exercise-nutrition management under the concept of ERAS were used to provide patients with surgical nursing work,and the postoperative recovery effect,blood glucose control quality,nutritional status,and complication rate of the two groups were compared.Results Comparing the postoperative recovery effect of the two groups,the exhaust time(43.21±3.16)h,the time to get out of bed(2.11±1.12)d and the hospitalization time(13.24±2.14)d in the observation group were less than those in the control group,and the difference was statistically significant(P<0.05).The blood glucose indexes of the two groups were compared,FBG(6.23±1.14)mmol/L,PBG(9.32±1.45)mmol/L and HbA1c(6.12±1.10)%of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The nutritional status of the two groups was compared,ALB(38.21±3.28)g/L,DPI(1.39±0.18)g/(kg·d),and nPCR(1.34±0.29)g/(kg·d)in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Comparing the incidence of complications between the two groups,the observation group 5.71%was significantly lower than the control group 22.86%,and the difference was statistically significant(P<0.05).Conclusion Exercise-nutrition management under the concept of ERAS can effectively shorten the postoperative recovery time after liver cancer combined with diabetes,better control blood glucose,maintain the balance of various nutritional indicators of the body,and control the occurrence of postoperative complications,in order to achieve more scientific treatment and recovery of diseases.