多学科协作快速康复对喉癌患者术后营养状况的影响

Effect of multidisciplinary collaborative enhanced recovery after surgery on postoperative nutritional status in patients with laryngeal cancer

目的探讨多学科协作快速康复对喉癌患者术后营养状况、并发症及血清纤维蛋白原(Fib)、血小板/淋巴细胞比值(PLR)和白介素-6(IL-6)水平的影响。方法选取2016年12月至2020年12月间铜川市人民医院行手术治疗的84例喉癌患者为研究对象,采用随机数表法分为研究组与对照组,每组42例。收治的研究组患者术后行多学科协作快速康复护理,对照组患者行常规护理。比较两组患者护理前后营养状况、并发症、生存质量及血清Fib、PLR和IL-6水平差异。结果护理前,两组患者白蛋白、血红蛋白、前白蛋白、总蛋白、转铁蛋白、红细胞、球蛋白和总淋巴细胞计数均较低,差异无统计学意义(P> 0.05)。护理后,研究组患者的白蛋白、血红蛋白、前白蛋白、总蛋白、转铁蛋白、红细胞、球蛋白和总淋巴细胞计数均高于对照组,差异均有统计学意义(均P <0.05)。护理后3d、7d,两组患者血清Fib、PLR和IL-6水平均呈降低趋势,且研究组均低于对照组,差异均有统计学意义(均P <0.05)。护理后,研究组患者的生活质量各维度评分均高于对照组,差异均有统计学意义(均P <0.05)。研究组术后并发症总发生率为11.9%,低于对照组的31.0%,差异有统计学意义(P <0.05)。结论多学科协作快速康复护理可有效提高患者营养状况及生活质量,减少术后并发症,且对抑制患者肿瘤复发及转移具有重要作用。

Objective To investigate the effects of multidisciplinary collaborative enhanced recovery after surgery on postoperative nutritional status,complications and serum fibrinogen( Fib),platelet to lymphocyte ratio( PLR) and interleukin-6( IL-6) levels in patients with laryngeal cancer. Methods From December 2016 to December 2020,84 patients with laryngeal cancer were selected at Tongchuan People’s Hospital. The patients were categorized into an experimental group and a control group with 42 patients each. The experimental group received nursing based on multidisciplinary collaborative enhanced recovery after surgery and the control group received conventional nursing care. Changes in nutritional status,complications and serum Fib,PLR and IL-6 levels were compared between the two groups. Results The levels of albumin,hemoglobin,prealbumin,total protein,transferrin,red blood cell,globulin and total lymphocyte count were low in both groups and there was no significant difference in these levels between the two groups before nursing( P > 0. 05). After nursing,the levels of albumin,hemoglobin,prealbumin,total protein,transferrin,red blood cell,globulin and total lymphocyte count were higher in the experimental group than in the control group( all P < 0. 05). The serum Fib,PLR and IL-6 levels decreased in the two groups at 3 d and 7 d after nursing,and the levels of these indexes were lower in the experimental group than in the control group( all P < 0. 05). After nursing,the scores of different domains of quality of life were higher in the experimental group than in the control group( all P < 0. 05). The overall incidence of postoperative complications was 11. 9% in the experimental group,which was lower than 31. 0% of the control group( P < 0. 05). Conclusion Multidisciplinary cooperative enhanced recovery after surgery can effectively improve the nutritional status and quality of life,reduce postoperative complications in patients with laryngeal cancer,and it plays an important role in reducing tumor recurrence and metastasis.