成人脊柱畸形患者术前营养干预的效果

Effect of preoperative nutritional intervention on adult patients with spinal deformity

目的探讨术前营养干预在成人脊柱畸形(adult spinal deformities,ASD)患者中的干预效果。方法选择2018年7月~2021年3月在本院接受手术治疗的86例ASD患者作为研究对象,采用随机数字表法分为对照组和观察组各43例。对照组常规饮食不予以特殊干预,观察组给予营养评估和营养师指导的营养干预。观察两组患者围手术期指标及术后并发症发生率;观察患者入组时、术前1 d时的蛋白质和热量摄入情况、CONUT评分、前清蛋白(prealbumin,PA)、血红蛋白(hemoglobin,Hb)水平、肱三头肌皮褶厚度(triceps skinfold thickness,TSF)和同侧上臂肌围(mid-arm muscle circumference,MAMC)。结果观察组住院时间显著短于对照组(P<0.05),术后并发症发生率显著低于对照组(P<0.05)。术前1 d时,观察组CONUT评分显著低于对照组,营养状况显著优于对照组,差异均有统计学意义(P<0.05)。术前1 d时,观察组患者PA、Hb、TSF、MAMC均显著高于入组时(P<0.05),也高于同期对照组(P<0.05)。结果术前营养指导和营养干预可改善营养不良ASD患者的术前营养状态,减少术后并发症。

Objective To investigate the effect of preoperative nutritional onadult spinal deformity(ASD).Methods A total of 86 patients with ASD who underwent surgery in our hospital from July 2018 to March 2021 were selected as the research objects andrandomly divided into the control group and the observation group with 43 cases in each group.The control group was given routine diet without special intervention,and the observation group was given nutritional intervention guided by nutritional evaluation and nutritionist.The perioperative indexes and the incidence of postoperative complications were observed in the two groups.The protein and calorie intake,CONUT score,prealbumin(PA),hemoglobin(Hb),triceps skinfold thickness(TSF)and mid-arm muscle circumference(MAMC)were observed at the time of enrollment and 1 day before operation.Results The hospital stay in the observation group was lower than that in the control group(P<0.05),and the incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).One day before operation,the CONUT score of the observation group was lower than that of the control group,and the nutritional status was better than that of the control group(P<0.05).The levels of PA,Hb,TSF and MAMC in the observation group were higher than those in the control group(P<0.05).Conclusion Preoperative nutritional guidance and nutritional intervention can improve the preoperative nutritional status of malnourished ASD patients and reduce the postoperative complications.