水解胶原蛋白肽联合乳清蛋白对改善胃肠手术患者营养状况的研究

Study of hydrolyzed collagen peptide combined with whey protein to improve the nutritional status of patients undergoing gastrointestinal surgery

目的探讨乳清蛋白联合水解胶原蛋白肽对胃肠道患者围术期营养支持的临床应用价值。方法选取2020年1月至2022年6月该院胃肠外科择期行胃肠道手术患者80例作为研究对象,并将其随机分为观察组和对照组,每组40例。两组患者入院时采用营养风险筛查2002量表进行营养风险筛查,当评分≥3分,对照组患者围术期口服或管饲输注乳清蛋白,观察组患者使用乳清蛋白联合水解胶原蛋白肽,对比两组患者入院时、术前1 d、术后7 d的总蛋白、清蛋白、前清蛋白水平及出院前营养状况及切口愈合率。结果两组患者入院时、术前1 d、术后7 d的总蛋白、清蛋白、前清蛋白水平随时间而改变,差异均有统计学意义(F_((时间)=1548.752,P_(时间)<0.05;F_(时间)=172.897,P_(时间)<0.05;F_(时间)=271.346,P_(时间)<0.05);观察组和对照组患者入院时、术前1 d、术后7 d的总蛋白、清蛋白水平组间效应差异均有统计学意义(F_(组间)=5.268,P_(组间)<0.05;F_(组间)=5.619,P_(组间)<0.05),但前清蛋白水平组间效应差异无统计学意义(F_(组间)=1.782,P_(组间)>0.05)。时间因素对总蛋白、清蛋白、前清蛋白水平的影响随着治疗方法不同而有所不同,差异均有统计学意义(F_(交互)=56.965,P_(交互)<0.05;F_(交互)=40.911,P_(交互)<0.05;F_(交互)=0.837,P_(交互)<0.05)。观察组营养正常率为32.5%,高于对照组的10.0%,差异有统计学意义(P<0.05)。观察组甲级切口愈合率为100.0%,高于对照组的90.0%,差异有统计学意义(P<0.05)。结论使用乳清蛋白联合水解胶原蛋白肽对有营养风险的胃肠手术患者围术期进行肠内营养支持,疗效具有优势。

Objective To explore the clinical value of whey protein combined with hydrolyzed collagen peptides in providing nutritional support during the perioperative period for gastrointestinal patients.Methods A total of 80 patients underwent elective gastrointestinal surgery in this hospital from January 2020 to June 2022 were selected and randomly divided into observation group and control group,with 40 cases in each group.The nutritional risk screening 2002 scale was used for nutritional risk screening in both groups upon admission.When the score≥3 points,the control group received oral or tube feeding infusion of whey protein during perioperative period,and the observation group received whey protein combined with hydrolyzed collagen peptide.The levels of total protein,albumin and prealbumin,nutritional status before discharge and incision healing rate were compared between the two groups at admission,1 d before surgery and 7 d after surgery.Results The levels of total protein,albumin and prealbumin in the two groups changed with time,and the differences were statistically significant(F_(time)=1548.752,P_(time)<0.05;F_(time)=172.897,P_(time)<0.05;F_(time)=271.346,P_(time)<0.05).There were significant differences in total protein and albumin levels between the observation group and the control group at admission,1 d before surgery and 7 d after surgery(F_(group)=5.268,P_(group)<0.05;F_(group)=5.619,P_(group)<0.05),but there was no significant difference in prealbumin level between the two groups(F_(group)=1.782,P_(group)>0.05).The effects of time factors on the levels of total protein,albumin and prealbumin were different with different treatment methods,and the differences were statistically significant(F_(interaction)=56.965,P_(interaction)<0.05;F_(interaction)=40.911,P_(interaction)<0.05;F_(interaction)=0.837,P_(interaction)<0.05).The comparison of nutritional status and incision healing rate before discharge showed that the normal nutritional rate in observation group was 32.5%,which was higher than that in control group(10.0%),and the difference was statistically significant(P<0.05).The first-grade incision healing rate in the observation group was 100.0%,which was higher than that in the control group(90.0%),and the difference was statistically significant(P<0.05).Conclusion Application of whey protein combined with hydrolyzed collagen peptide in the perioperative enteral nutrition support for gastrointestinal surgery patients with nutritional risks has an advantage.