基于NRS2002营养筛查的围术期营养管理对口腔癌皮瓣修复患者心理韧性和营养状态的研究

Study of perioperative nutrition management based on NRS2002 nutrition screening on psychological resilience and nutritional status in patients with oral cancer flap repair

目的探讨基于NRS2002营养筛查的围术期营养管理对口腔癌皮瓣修复术患者营养风险、心理韧性和营养状态的研究,为NRS2002营养筛查在口腔癌皮瓣修复术中的推广应用提供有效证据。方法选取2022年6月至2023年5月在本院接受治疗的口腔癌皮瓣修复术患者,符合纳入标准的120例作为研究对象,随机分成观察组(60例)和对照组(60例),给予对照组常规营养管理,在此基础上给予观察组基于NRS2002营养筛查为指导的围术期营养管理,比较两组患者干预前后的营养风险[营养风险筛查简表(NRS2002)]、心理韧性[心理弹性量表(CD-RISC)评分]、营养状态[主观全面营养评估量表(SGA)、体质指数(BMI)]的变化,并观察比较两组患者术后康复情况。结果观察组NRS2002评分结果显示围术期患者营养风险较干预前降低(P<0.05),有显著统计学意义;观察组心理弹性量表(CD-RISC)评分显示围术期患者心理韧性高于干预前(P<0.05),有显著统计学意义;观察组SGA量表评分下降幅度要大于对照组,观察组BMI下降幅度要小于对照组(P<0.05),差异有统计学意义;观察组患者术后鼻饲周期、住院周期明显低于对照组,且差异有统计学意义(P<0.05)。两组年龄、肿瘤大小、肿瘤部位、文化程度、家庭状况,社会关系等结果无明显差异及统计学意义。结论基于NRS2002营养筛查的围术期营养管理有助于改善口腔癌皮瓣修复术患者的营养状态,大大增强患者的心理韧性,对促进患者康复有积极指导意义,可以推广应用。

Objective To explore the effects of perioperative nutrition management based on NRS2002 nutrition screening on nutritional risk,psychological resilience and nutritional status of patients undergoing oral cancer flap repair,and to provide effective evidence for the promotion and application of NRS2002 nutrition screening in oral cancer flap repair.Methods A total of 120 patients with flap repair for oral cancer who received treatment in our hospital from June 2022 to May 2023 meeting the inclusion criteria were selected as the study objects.They were randomly divided into the observation group(60 cases)and the control group(60 cases).The control group was given routine nutrition management.Based on it,perioperative nutrition management guided by NRS2002 nutritional screening was given to the observation group.The changes of nutritional risk[NRS2002],mental toughness[CD-RISC score],and nutritional status[SGA,body mass index]were compared between the two groups.The postoperative rehabilitation of the two groups were observed and compared.Results The NRS2002 score of the observation group showed that the nutritional risk of the patients in perioperative period was lower than that before intervention(P<0.05),with statistical significance;The psychological resilience scale(CDRISC)score of the observation group showed that the psychological toughness of the patients in perioperative period was higher than that before intervention(P<0.05),which had significant statistical significance;The decrease of SGA scale score in the observation group was greater than that in the control group,and the decrease of BMI in the observation group was smaller than that in the control group(P<0.05),the difference was statistically significant.Postoperative nasal feeding cycle and hospitalization cycle in observation group were significantly lower than those in control group,and the difference was statistically significant(P<0.05).There were no significant differences in age,tumor size,tumor site,education level,family status and social relationship between the two groups.Conclusions Perioperative nutrition management based on NRS2002 nutrition screening is helpful to improve the nutritional status of patients undergoing oral cancer flap repair.It greatly enhances the psychological toughness of patients,and has positive guiding significance for promoting the rehabilitation of patients,which can be widely applied.