营养风险筛查及个体化干预对胃肠恶性肿瘤患者围术期生活质量的影响

The effect of nutritional risk screening and individualized intervention on the perioperative quality of life of patients with gastrointestinal malignant tumors

目的探讨营养风险筛查及个体化干预对胃肠恶性肿瘤患者围术期生活质量的影响。方法选取本院普外科2017年1月至2020年4月胃肠恶性肿瘤手术患者60例,随机分为对照组(n=30)和观察组(n=30)。对照组围术期接受常规饮食护理指导,观察组围术期接受营养风险筛查及个体化饮食指导和干预。对比两组术前和术后2周、术后3个月的营养整体评估(PG-SGA)得分、营养水平(ALB、PA、TP、TLC)和远期生活质量(QLQ-C30)。结果两组术前和术后2周的PG-SGA及QLQ-C30得分比较差异不明显(P>0.05);术后3个月随访,对照组PG-SGA评分明显低于观察组(P<0.05)。两组术前和术后2周的ALB、PA、TP、TLC水平比较无明显差异(P>0.05);术后3个月随访,两组ALB、PA、TP、TLC营养水平均有增长,但观察组增长水平明显高于对照组(P<0.05)。对照组术前、术后2周、术后3个月QLQ-C30各领域得分及总体健康状况得分差异不明显(P>0.05);观察组术后3个月QLQ-C30各领域得分及总体健康状况得分明显高于术前及术后2周的水平,差异明显(P<0.05)。结论营养风险筛查及个体化干预,可明显改善胃肠恶性肿瘤患者围术期营养不良的程度和营养水平,提高患者术后远期生存质量。

Objective:To investigate the effect of nutritional risk screening and individualized intervention on the perioperative quality of life of patients with gastrointestinal malignant tumors.Methods:A total of 60 patients with gastrointestinal malignant tumor surgery in our hospital from January 2017 to April 2020 were selected and randomly divided into control group(n=30)and observation group(n=30).The control group received routine diet nursing guidance during the perioperative period,and the observation group received nutritional risk screening and individualized diet guidance and intervention during the perioperative period.The nutritional holistic assessment(PG-SGA)scores,nutritional levels(ALB,PA,TP,TLC)and long-term quality of life(QLQ-C30)were compared between the two groups before operation,2 weeks after operation,and 3 months after operation.Results:There was no significant difference in the PG-SGA and QLQ-C30 scores between the two groups before and 2 weeks after the operation(P>0.05);after 3 months of follow-up,the PG-SGA score of the control group was significantly lower than that of the observation group(P<0.05);There was no significant difference in the levels of ALB,PA,TP,and TLC between the two groups before and 2 weeks after the operation(P>0.05);3 months after the operation,the nutritional levels of ALB,PA,TP,and TLC were both increased,the growth level of the observation group was significantly higher than that of the control group(P<0.05);the QLQ-C30 scores in various fields and overall health scores were not significantly different in the control group before operation,2 weeks after operation,and 3 months after operation(P>0.05).The scores of QLQ-C30 in various fields and overall health status of the observation group at 3 months after surgery were significantly higher than those before and 2 weeks after surgery,with significant differences(P<0.05).Conclusion:Nutrition risk screening and individualized intervention can significantly improve the perioperative malnutrition and nutritional level of patients with gastrointestinal malignant tumors,and improve the long-term quality of life of patients after surgery.