营养风险评估下护理在下颌骨肿瘤腓骨肌皮瓣移植术患者中的应用效果

Application of nursing under nutritional risk assessment in patients with mandibular tumors undergoing fibula musculocutaneous flap grafting

目的探究营养风险评估下护理在下颌骨肿瘤腓骨肌皮瓣移植术患者中的临床效果。方法选取南京医科大学第一附属医院(江苏省人民医院)口腔耳鼻喉科2018年1月至2022年12月收治的120例下颌骨肿瘤腓骨肌皮瓣移植术患者作为观察对象,以1~120的顺序编号,单数为参照组,双数为干预组,参照组(60例)实施常规康复护理措施,干预组(60例)实施营养风险评估康复护理措施。于干预前、干预14 d后,对2组患者颌关节功能、营养指数、并发症等情况进行比较分析。结果干预前,2组患者下颌关节功能、营养指数比较差异无统计学意义(P>0.05);干预14 d后,干预组下颌运动评分、关节压诊评分、肌肉压诊评分等下颌关节功能水平高于参照组(P<0.05),干预组转铁蛋白(TRF)、白蛋白(ALB)、总蛋白(TP)、前白蛋白(PAB)等营养指标优于参照组(P<0.05),干预组胃肠紊乱、感染、创口肿胀、营养不良等并发症发生率低于参照组(P<0.05)。结论营养风险评估下康复护理有助于提高下颌骨肿瘤腓骨肌皮瓣移植术患者颌关节功能,改善机体各项营养指标,降低术后并发症发生率。

Objective To explore the clinical effect of nursing under nutritional risk assessment(NUNRA)in patients with mandibular tumors undergoing fibula musculocutaneous flap grafting.Methods A total of 120 patients with mandibular tumor who underwent fibula musculocutaneous flap grafting in the Department of Otolaryngology of the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2022 were selected as research objects.They were numbered in the order of 1-120 and divided into control group and intervention group according to odd and even numbers,with 60 cases in each group.The control group received routine rehabilitation nursing.The intervention group were given NUNRA.The mandibular joint function,nutritional index and complications were compared between the two groups before intervention and 14 d after intervention.Results There was no significant difference in the mandibular joint function or nutrition index between the two groups before intervention(P>0.05).After 14 d of intervention,the scores of mandibular movement,joint pressing diagnosis and muscle pressing diagnosis of the intervention group were higher than those of the control group(P<0.05);the nutritional indexes,such as transferrin(TRF),albumin(ALB),total protein(TP)and prealbumin(PAB)in the intervention group were superior to those in the control group(P<0.05);and the incidences of gastrointestinal disorders,infection,wound swelling and malnutrition in the intervention group were lower than those in the control group(P<0.05).Conclusion NUNRA can improve mandibular function and nutrition index and reduce the incidences of postoperative complications in patients with mandibular tumors undergoing fibula musculocutaneous flap grafting.