营养和运动预适应对老年消化道肿瘤患者术后谵妄和术后恢复情况的影响

Effect of Nutrition and Exercise Pre-adaptation on Postoperative Delirium and Postoperative Recovery in Elderly Patients with Gastrointestinal Cancer

目的:探讨营养和运动预适应对老年消化道肿瘤患者术后谵妄和术后恢复情况的影响。方法:将中国人民解放军联勤保障部队第九一〇医院外科于2017年4月-2021年2月收治的老年消化道肿瘤患者142例进行研究分析,所有患者均行消化道肿瘤切除术。按随机数表法分为试验组和对照组,每组71例。纳入研究的142例消化道肿瘤患者,其中试验组2例病例脱落,剩余69例;对照组3例病例脱落,剩余68例。对照组给予常规护理干预,试验组在对照组基础上联合运动和营养预适应锻炼。比较两组近期并发症发生率、营养状况和术后恢复情况等。结果:试验组术后谵妄发生率、谵妄持续时间、近期其他并发症发生率、电解质紊乱发生率、体重下降情况、术后排气时间、可正常进食时间、下床活动时间和住院时间均优于对照组(P<0.05)。干预前,两组主观整体营养状况评估量表(patient-generated subjective global assessment,PG-SGA)评分和营养风险筛查评分(nutritional risk screening score table,NRS 2002)对比,差异均无统计学意义(P>0.05);干预后,两组PG-SGA评分和NRS 2002评分较干预前均升高,但试验组干预后与干预前对比,差异均无统计学意义(P>0.05),对照组干预后均高于干预前(P<0.05),且试验组均低于对照组(P<0.05)。结论:营养和运动预适应可明显改善老年消化道肿瘤患者术后谵妄,减少了并发症的发生,促进了患者术后恢复。

Objective:To investigate the effect of nutrition and exercise pre-adaptation on postoperative delirium and postoperative recovery in elderly patients with gastrointestinal cancer.Method:A total of 142 elderly patients with gastrointestinal cancer admitted to Surgical Department of the 910th Hospital of PLA Joint Logistic Support Force from April 2017 to February 2021 were analyzed,all patients were given resection of digestive tract tumor.They were divided into the experimental group(n=71)and the control group(n=71)by random number table method.Among 142 patients with gastrointestinal cancer,2 cases fell off in the experimental group,the remaining 69 cases;3 cases in the control group,and the remaining 68 cases.The control group was given routine nursing intervention,and on the basis of the control group,the experimental group was given exercise and nutritional pre-adaptation exercise.The incidence of recent complications,nutritional status and postoperative recovery were compared between two groups.Result:The incidence of postoperative delirium,duration of delirium,incidence of recent complications,incidence of electrolyte disorders,weight loss,postoperative exhaust time,normal eating time,ambulation time and hospitalization time in the experimental group were better than those in the control group(P<0.05).Before intervention,there were no significant differences in the scores of PG-SGA and NRS 2002 between two groups(P>0.05);after intervention,the scores of PG-SGA and NRS 2002 of two groups were higher than those before intervention,however,there were no significant differences between the experimental group after intervention and before intervention(P>0.05),after intervention,the control group were higher than those before intervention(P<0.05),and the experimental group were lower than those of the control group(P<0.05).Conclusion:Nutrition and exercise pre-adaptation can significantly improve postoperative delirium in elderly patients with gastrointestinal cancer,reduce the incidence of complications,and promote postoperative recovery.