优化营养路径对结直肠癌术后胃肠功能及免疫指标的影响

Effect of optimized nutritional pathway on gastrointestinal function and immune indexes after colorectal cancer surgery

目的探讨优化营养路径对结直肠癌(CRC)术后胃肠功能及免疫指标影响。方法选取2018年4月至2021年5月于江苏省连云港市第一人民医院行根治术的CRC患者136例,根据随机数字表法将患者分为常规组(68例,采用常规营养护理)及优化组(68例,采用优化营养路径护理)。比较两组术后胃肠功能恢复时间、免疫指标、术后营养风险评分、并发症发生率。结果优化组术后肠鸣音出现时间、首次肛门排气时间、术后首次排便时间、首次进食时间、恢复普食时间及并发症发生率低于常规组(P<0.05);两组术后7 d CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均低于本组术前1 d,且优化组CD4^(+)、CD4^(+)/CD8^(+)水平高于常规组,CD8^(+)水平低于常规组(P<0.05);两组术后7 d营养风险评分均低于入组时,且优化组低于常规组(P<0.05)。结论在CRC采用优化营养路径,有助于提升胃肠功能、免疫指标及营养水平,减少术后并发症发生风险。

Objective To investigate the effect of optimized nutritional pathway on gastrointestinal function and immune indexes after colorectal cancer(CRC)surgery.Methods A total of 136 patients with CRC who underwent radical resection in the First People’s Hospital of Lianyungang,Jiangsu Province from April 2018 to May 2021 were selected.According to the random number table method,the patients were divided into routine group(n=68,with routine nutritional care)and optimization group(n=68,with optimized nutritional path),the recovery time of gastrointestinal function,immune indexes,postoperative nutritional risk score,and incidence of complications were compared between the two groups.Results The time of bowel sounds,time of first anal exhaust,time of first defecation,time of first eating,time of resuming normal eating,and incidence of complications in the optimization group were lower than those in the conventional group(P<0.05).The levels of CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in the two groups at seven days postoperative were lower than those at one day before operation,and the levels of CD4^(+)and CD4^(+)/CD8^(+)in the optimization group were higher than those in the conventional group,and the level of CD8^(+)was lower than that in the conventional group(P<0.05).The nutritional risk scores of the two groups at seven days after operation were lower than those at enrollent,and the optimization group was lower than the conventional group(P<0.05).Conclusion The optimized nutritional pathway in CRC is helpful to improve gastrointestinal function,immune indicators and nutritional level,and reduce the risk of postoperative complications.