EN支持中联用乳清蛋白与水解胶原蛋白肽对有营养风险的胃肠道手术患者临床结局的影响

EN supports the effect of whey protein and hydrolyzed collagen peptide on clinical outcomes in patients undergoing gastrointestinal surgery with nutritional risks

目的:观察肠内营养(EN)支持中联合应用乳清蛋白与水解胶原蛋白肽对有营养风险的胃肠道手术患者临床结局的影响。方法:选取2020年1月1日至2022年6月30日于广西科技大学第一附属医院胃肠外科择期行胃肠道手术的80例有营养风险〔入院时采用营养风险筛查量表2002(NRS-2002)进行营养风险筛查,评分≥3分〕的患者为研究对象,随机分为观察组和对照组,每组各40例。在围手术期的EN支持中,给予对照组口服或管饲输注乳清蛋白,给予观察组口服或管饲输注乳清蛋白联合水解胶原蛋白肽,对比两组的临床结局。结果:观察组术后切口的甲级愈合率为100.00%,显著高于对照组的90.00%,差异有统计学意义(P<0.05)。出院前,观察组中营养正常患者的占比为27.50%,显著高于对照组的10.00%,差异有统计学意义(P<0.05)。观察组术后肺部感染的发生率为2.50%,显著低于对照组的20.00%,差异有统计学意义(P<0.05)。结论:对于有营养风险的胃肠道手术患者来说,在围手术期的EN支持中联合应用乳清蛋白与水解胶原蛋白肽能显著改善其营养状态,促进切口的愈合,降低术后并发症的发生率,临床应用优势明显。

Objective:To observe the effect of combined application of whey protein and hydrolyzed collagen peptide in enteral nutrition(EN)support on the clinical outcome of patients undergoing gastrointestinal surgery at nutritional risk.Method:Eighty patients with nutritional risk who underwent elective gastrointestinal surgery in the Gastrointestinal Surgery Department of the First Affiliated Hospital of Guangxi University of Science and Technology from January 1,2020 to June 30,2022 were selected as the study objects(nutritional risk screening was performed by the nutritional risk screening Scale 2002(NRS-2002)on admission,with scores≥3),and randomly divided into the observation group and the control group.There were 40 patients in each group.In perioperative EN support,the control group was given oral or tube feeding whey protein,and the observation group was given oral or tube feeding whey protein combined with hydrolyzed collagen peptide.The clinical outcomes of the two groups were compared.The results showed that:The Grade A healing rate of incision in the observation group was 100.00%,which was significantly higher than that in the control group(90.00%),and the difference was statistically significant(P<0.05).Before discharge,the proportion of patients with normal nutrition in the observation group was 27.50%,which was significantly higher than 10.00%in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative pulmonary infection in the observation group was 2.50%,significantly lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusions:For patients with gastrointestinal surgery at nutritional risk,the combined application of whey protein and hydrolyzed collagen peptide in perioperative EN support can significantly improve their nutritional status,promote incision healing,and reduce the incidence of postoperative complications,showing obvious clinical advantages.