胃肠道肿瘤患者术前口服营养补充护理干预方案的构建及应用

Development and application of a nursing intervention program aimed at preoperative oral nutritional supplementation for patients with gastrointestinal neoplasm

目的 探讨术前口服营养补充护理对存在营养风险的胃肠道恶性肿瘤患者的干预效果,以促进患者预康复。方法 采用便利抽样法选取胃肠外科收治的存在营养风险的胃肠道肿瘤患者103例为研究对象,根据病区分为对照组(n=52)和观察组(n=51),对照组按加速康复外科理念实施常规术前营养护理,观察组在对照组基础上实施术前口服营养补充营养护理干预。比较两组围手术期营养状况、下床活动时间和胃肠功能。结果 对照组47例、观察组46例患者完成研究。两组术后第3天血清白蛋白、前白蛋白、视黄醇结合蛋白值显著低于入院时(均P<0.05)。术后第3天观察组血清白蛋白、前白蛋白值显著高于对照组,术后首次下床时间、首次排气时间、首次排便时间和首次进食流食时间显著早于对照组(均P<0.05)。结论 对胃肠道肿瘤患者实施术前口服营养补充营养护理干预,可有效改善患者术后营养状况,促进患者康复。

Objective To evaluate the effect of preoperative intake of oral nutritional supplements(ONS)in gastrointestinal cancer patients at high risk of malnutrition,and to promote prehabilitation.Methods A convenient sample of 103 gastrointestinal cancer patients at nutritional risk and candidate to major surgery was assigned to a control group of 52 or an intervention group of 51 according to the wards where they were treated.The control group received routine preoperative nutrition management following enhanced recovery after surgery protocols,while the intervention group were administered a standard ONS.Nutritional status,out-of-bed mobilization time and gastrointestinal function between the two groups were compared.Results Forty-seven patients in the control group and forty-six in the intervention group completed the study.Both groups had lower values of serum albumin,prealbumin,and retinol-binding protein on postoperative day 3 than admission(all P<0.05).The intervention group had significantly higher serum albumin and prealbumin level on postoperative day 3 compared with the control group(both P<0.05).Time to first ambulation,flatus,faeces,and fluid intake in the intervention group were significantly shortened than the control group(all P<0.05).Conclusion A preoperative nursing intervention with ONS improves postoperative nutritional status and recovery of patients with gastrointestinal neoplasm.