加速康复外科理念在老年食管癌病人营养管理中的应用

Application of the concept of enhanced recovery after surgery in nutritional management of elderly patients with esophageal cancer

目的探讨基于加速康复外科(enhanced recovery after surgery,ERAS)的营养管理模式在老年食管癌病人中的应用效果。方法将2021年5~12月拟行食管癌根治术的100例老年食管癌病人随机分为观察组和对照组,每组各50例。对照组采用传统营养管理模式,观察组采用ERAS营养管理模式,比较2组胃肠道功能恢复和并发症发生情况、术后1个月营养状况和生活质量。结果观察组首次排气时间、首次排便时间、下床活动时间和住院时间显著短于对照组(P<0.01)。干预1个月后,观察组血清总蛋白、白蛋白、前白蛋白和体质量均高于对照组(P<0.01)。观察组术后并发症发生率显著低于对照组(4%比16%,P=0.012)。干预后,2组健康状况调查表(SF-36)各维度得分均显著增加,且观察组各维度得分均显著高于对照组(P<0.01)。结论基于ERAS理念对老年食管癌病人进行术前和术后营养管理,可促进病人胃肠道功能恢复,改善营养状况,降低术后并发症发生率,提高病人生活质量。

Objective To explore the effects of nutrition management mode based on enhanced recovery after surgery(ERAS)in the elderly patients with esophageal cancer.Methods From May to December 2021,a total of 100 elderly patients with esophageal cancer undergoing radical resection were randomly divided into observation group and control group,with 50 cases in each group.The patients in control group received traditional nutrition management,while the patients in observation group received ERAS nutrition management.The recovery of gastrointestinal function,the incidence of complications,nutritional status and quality of life one month after surgery were compared between the two groups.Results The time to first exhaust,the time to first defecation,the time to getting out of bed and the hospitalization time in the observation group were significantly shorter than those in the control group(P<0.01).After intervention,the levels of serum total protein,albumin,prealbumin and body weight one month later in the observation group were significantly higher than those in the control group(P<0.01).The incidence rate of postoperative complications in the observation group was significantly lower than that in the control group(4%vs 16%,P=0.012).After the intervention,the scores of all dimensions of SF-36 in both groups increased significantly,especially in the observation group(P<0.01).Conclusions Preoperative and postoperative nutritional management based on ERAS can promote the recovery of gastrointestinal function,improve the nutritional status,reduce the incidence of postoperative complications and enhance the quality of life of the elderly patients with esophageal cancer.