集束化干预在中下段食管癌切除术后患者肠内营养管理中的应用

Application of cluster intervention in enteral nutrition management of patients after resection of middle and lower esophageal cancer

目的探讨集束化干预在中下段食管癌切除术后患者肠内营养管理中的应用效果。方法选取该院胸腔外科2021年3-12月中下段食管癌切除术后行肠内营养患者107例作为研究对象,按照随机数字表法分为试验组(54例)和对照组(53例)。对照组采用常规肠内营养干预,试验组采用集束化肠内营养干预。治疗1周后,观察比较两组患者肠内营养喂养不耐受发生率、营养状况[BMI、前白蛋白(PA)、血清白蛋白(ALB)、血红蛋白(Hb)]及术后住院时间。结果试验组(9例)发生喂养不耐受少于对照组(19例),差异有统计学意义(P<0.05)。试验组PA、Hb分别为(205.37±63.14)mg/L、(111.06±23.33)g/L,高于对照组的(176.33±70.23)mg/L、(101.23±21.73)g/L,差异有统计学意义(P<0.05)。试验组术后住院时间[(18.45±4.63)d]短于对照组[(23.78±5.03)d],差异有统计学意义(P<0.05)。结论在中下段食管癌切除术后患者肠内营养管理中实施集束化干预,可降低患者肠内营养喂养不耐受发生率,改善患者营养状况和临床结局。

Objective To explore the application effect of cluster intervention in enteral nutrition management of patients after resection of middle and lower esophageal cancer.Methods A total of 107 patients who underwent enteral nutrition after resection of middle and lower esophageal cancer in thoracic surgery department of our hospital from March to December 2021 were selected as the research objects.According to the random number table method,they were divided into experimental group(54 cases)and control group(53 cases).The control group was treated with routine enteral nutrition intervention,and the experimental group was treated with cluster enteral nutrition intervention.After one week of treatment,the incidence of enteral nutrition intolerance,nutritional status[BMI,prealbumin(PA),serum albumin(ALB),hemoglobin(Hb)]and postoperative hospital stay were observed and compared between the two groups.Results The incidence of feeding intolerance in test group(9 cases)was less than that in control group(19 cases),and the difference was statistically significant(P<0.05).The experimental group had higher PA and Hb respectively as(205.37±63.14)mg/L and(111.06±23.33)g/L than(176.33±70.23)mg/L and(101.23±21.73)g/L in the control group,and their difference was statistically significant(P<0.05).The postoperative hospitalization time of the experimental group(18.45±4.63)d was shorter than that of the control group(23.78±5.03)d,and the difference was statistically significant(P<0.05).Conclusion The implementation of cluster intervention in the enteral nutrition management of patients with middle and lower esophageal cancer after resection can reduce the incidence of enteral nutrition feeding intolerance and improve the nutritional status and clinical outcomes of patients.