Application of early enteral nutrition nursing based on enhanced recovery after surgery theory in patients with digestive surgery

BACKGROUND Postoperative nursing can improve the restlessness and gastrointestinal function of patients with tracheal intubation under general anesthesia in digestive surgery.Wide application of various nursing methods and routine nursing in periop-erative nursing of patients with general anesthesia in digestive surgery.AIM To investigate the impact of early postoperative enteral nutrition nursing based on the enhanced recovery after surgery(ERAS)theory on postoperative agitation and gastrointestinal recovery in patients undergoing general anesthesia that experienced tracheal intubation.METHODS The data of 126 patients with digestive surgery from May 2019 to February 2022 were retrospectively analyzed.According to different nursing methods,they were divided into control group and observation group,with 63 cases in observation group and 63 cases in control group.The patients in the control group had standard perioperative nursing care,whereas those in the observation group got enteral nourishment as soon as possible after surgery in accordance with ERAS theory.Both the rate and quality of gastrointestinal function recovery were compared between the two groups after treatment ended.Postoperative anes-thesia-related adverse events were tallied,patients'nutritional statuses were monitored,and the Riker sedation and agitation score(SAS)was used to measure the incidence of agitation.RESULTS When compared to the control group,the awake duration,spontaneous breathing recovery time,extubation time and postoperative eye-opening time were all considerably shorter(P<0.05).There was no significant difference in the recovery time of orientation force between the two groups(P>0.05);however,the observation group had a lower SAS score than the control group(P<0.05).The recovery time for normal intestinal sounds,the time it took to have the first postoperative exhaust,the time it took to have the first postoperative defecation,and the time it took to have the first postoperative half-fluid feeding were all faster in the observation group than in the control group(P<0.05);Fasting blood glucose was lower in the observation group compared to the control group(P<0.05),while the albumin and hemoglobin levels were higher on the first and third postoperative days;however,there was no statistically significant difference in the incidence of anesthesia-related adverse reactions between the two groups(P>0.05).CONCLUSION The extremely early postoperative enteral nutrition nursing based on ERAS theory can reduce the degree of agitation,improve the quality of recovery,promote the recovery of gastrointestinal function,and improve the nutritional status of patients in the recovery period after tracheal intubation under general anesthesia.

Examining the impact of early enteral nutritional support on postoperative recovery in patients undergoing surgical treatment for gastrointestinal neoplasms

BACKGROUND Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment.Surgery is the main treatment for these patients,but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction,leading to further deterioration of the nutritional status.Early enteral nutrition support is hypothesized to be helpful in improving this situation,but the exact effects have yet to be studied in depth.AIM To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors,with the expectation that by improving the nutritional status of patients,the recovery process would be accelerated and the incidence of complications would be reduced,thus improving the quality of life.METHODS A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed.Fifty-three of these patients received complete parenteral nutrition support as the control group for this study.The other 68 patients received early enteral nutritional support as the observation group of this study.The clinical indicators comparing the two groups included time to fever,time to recovery of postoperative bowel function,time to postoperative exhaustion,and length of hospital stay.The changes in immune function and nutritional indexes in the two groups were compared.Furthermore,we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients.Finally,the occurrence of postoperative complications between the two patient groups was also compared.RESULTS The postoperative fever time,postoperative bowel function recovery time,postoperative exhaustion time,and hospitalization time were all higher in the control group than in the observation group(P<0.05).The levels of CD3+,CD4+,immunoglobulin(Ig)A,IgM,and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively,while CD8+was lower than in the control group(P<0.05).Total protein,albumin,prealbumin,and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively(P<0.05).The SF-36 scores of patients in the observation group were significantly higher than those in the control group(P<0.0001).The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group(P=0.021).CONCLUSION We found that patients with gastrointestinal tumors are nutritionally vulnerable,and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery.This program can not only improve the immune function of the patient and protect the intestinal function,but it can also help to improve the quality of life of the patient.However,this program will increase the incidence of complications in patients.Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer.The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.

Exploring choices of early nutritional support for patients with sepsis based on changes in intestinal microecology

BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.

Development of a prediction model for enteral feeding intolerance in intensive care unit patients:A prospective cohort study

BACKGROUND Enteral nutrition(EN)is essential for critically ill patients.However,some patients will have enteral feeding intolerance(EFI)in the process of EN.AIM To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care unit.METHODS A prospective cohort study was performed.The enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were recorded.The baseline data and influencing factors were compared.Logistic regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal validation.RESULTS The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with EFI.After the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were identified.In the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.

胸腹腔镜食管癌根治术联合早期肠内营养支持治疗老年食管癌的临床观察

目的:研究胸腹腔镜根治术联合早期肠内营养支持治疗老年食管癌的效果。方法:研究对象选取2018年01月至2021年12月我院收治的96例老年食管癌患者,按照随机数字法分为观察组和对照组,每组各48例。对照组术后采取肠外营养支持治疗,观察组术后采取肠内营养支持治疗,比较两组患者术后住院时间、肛门排气时间、首次排便时间、下床活动时间、恢复饮食时,以及术前及术后7 d的营养相关状况指标白蛋白(ALB)、总蛋白(TP)、前白蛋白(PA)和体质量指数(BMI),免疫功能相关指标CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),观察两组主要并发症的发生情况。结果:观察组住院时间、肛门排气时间、首次排便时间、恢复饮食时间均少于对照组(P<0.05);观察组术后7 d的ALB、TP、PA、BMI均高于对照组(P<0.05);观察组术后7 d的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05);观察组吻合口瘘、肺部并发症及总并发症的发生率(P<0.05),均低于对照组。结论:早期肠内营养支持可以有效改善老年患者在胸腹腔镜联合食管癌根治术后营养状态,增强免疫功能,减少并发症,促进术后恢复,具有较大临床价值。

早期肠内营养乳剂支持疗法治疗重症脑出血患者的临床研究

目的研究早期肠内营养支持疗法治疗重症脑出血患者的临床疗效及有效性分析。方法选择2021年10月至2023年2月期间于四川大学华西医院住院的108例重症脑出血患者作为研究对象,以随机数字表法分为对照组和观察组,每组各54例。对照组给予一般鼻饲饮食,观察组给予肠内营养乳剂,比较2组营养状况、急性生理与慢性健康评分(APACHEⅡ)、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、肠黏膜屏障功能、免疫指标、并发症发生情况。结果治疗前,2组营养状况[血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)]、APACHEⅡ评分、NIHSS评分、GCS评分、肠黏膜屏障功能[二胺氧化酶(DAO)、D-乳酸(D-LAC)、内毒素(ET)]、免疫指标[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]水平比较,差异无统计学意义(P>0.05);治疗2周后,观察组营养状况、APACHEⅡ评分、NIHSS评分、GCS评分、肠黏膜屏障功能、免疫指标水平较对照组更佳,差异有统计学意义(P<0.05);观察组并发症发生率为7.41%,较对照组的29.63%更低,差异有统计学意义(P<0.05)。结论对重症脑出血患者早期给予肠内营养乳剂,能够改善患者的营养状况、肠黏膜屏障功能,增强免疫力,减少并发症,减轻神经功能缺损,促进患者病情恢复,值得推广。

循证护理对食管癌术后早期肠内营养支持的作用分析

目的:分析循证护理对食管癌术后早期肠内营养支持效果的影响。方法:将2021年1月—2023年6月于滨州医学院附属医院进行治疗的74例食管癌术后早期肠内营养支持患者随机分为对照组(37例,常规护理)和观察组(37例,常规护理联合循证护理)。对比两组术后胃肠动力恢复指标、术后管道留置时间、住院时间、并发症发生率、血清学指标。结果:与对照组相比,观察组术后肛门排气时间、排便时间、进食流质食物时间均较短(P<0.05);与对照组相比,观察组术后胃管、胸腔引流管、腹腔引流管留置时间及住院时间均较短(P<0.05);观察组并发症发生率低于对照组(P=0.017);术后1周,两组血清白蛋白、总蛋白水平升高,观察组高于对照组(P<0.05)。结论:食管癌患者术后早期肠内支持期间通过应用循证护理有助于减少相关并发症,加快患者术后康复以及改善机体营养状况。

重症患者营养支持现状对临床结局的影响

目的调查分析重症患者营养支持现状对其营养指标及临床结局的影响。方法本研究为一项单中心回顾性队列研究,回顾性选取2022年1月至6月入住南京大学医学院附属鼓楼医院ICU病区且符合入组条件的患者为研究对象,探究重症患者营养支持状况对临床结局的影响。结果共纳入126名重症患者(女性35例,男性91例),年龄为(63.93±18.78)岁。患者SOFA评分和APACHE-Ⅱ评分分别为(6.62±4.11)分、(20.92±7.51)分。91例(72.2%)为高营养风险患者(NUTRIC评分≥6),35例(27.8%)为低营养风险患者(NUTRIC评分<6),接受营养支持的患者有111例(88.1%)。在接受肠内营养的86例患者中,有55例(64.0%)患者早期肠内营养支持开始时机≤入室48 h。在进行营养支持的111例患者中,23例(20.7%)患者能量和蛋白质同时达标时间≤入室72 h。高营养风险组患者的总住院时间更久(P<0.05),早期肠内营养组患者的28 d死亡率更低(P<0.01),蛋白质早期充足组患者入室7 d内人血白蛋白的变化值更大(P<0.05)。结论所有ICU住院时间超过48 h的患者,均推荐入室48 h内开展早期肠内营养支持,早期肠内营养支持可以降低其28 d死亡率;早期蛋白质或者能量是否充足可能对ICU住院患者临床结局没有影响。

2023版《ESPEN实践指南:家庭肠外营养》解读

2023年1月,欧洲临床营养与代谢协会(ESPEN)发布最新家庭肠外营养指南——《ESPEN实践指南:家庭肠外营养》,为临床实践中提供适当和安全的建议。该指南基于先前发表的指南,提供最新证据和意见,并将建议及声明转换为流程图形式,内容更具逻辑性。该指南从家庭肠外营养适应证、中心静脉通路装置与输液泵、输液导管与中心静脉通路装置部位的护理、营养混合液、程序监测和管理6个方面提出71条建议、5项声明,现对该指南的主要内容进行解读,希望为我国家庭肠外营养的开展及应用提供有益参考。

早期肠内营养护理干预用于神经内科重症患者营养状况及并发症的改善

目的 早期肠内营养护理干预用于神经内科重症患者营养状况及并发症的改善。方法 选取南平市第一医院2020年1月至2022年1月期间的神经内科重症治疗患者100例作为研究对象。采取奇偶数分组的方式将其均分为两组。对照组50例实施常规护理,观察组50例采取早期肠内营养护理干预,对比组间患者护理满意度、营养指标、并发症发生率以及舒适度评分。结果 护理后,观察组护理满意度、总蛋白、白蛋白、前白蛋白以及舒适度评分均高于对照组(均P <0.05);观察组并发症发生率低于对照组(P <0.05)。结论 通过将早期肠内营养支持应用于神经内科重症患者临床救治中,可显著改善患者营养状态和身体质量,降低并发症发生率,为机体康复提供必需营养。

不同营养支持方式对鼻咽癌放疗患者胃肠道功能及生活质量的影响

目的 探讨肠内营养支持和肠外营养支持对鼻咽癌放疗患者胃肠道功能及生活质量的影响。方法依据营养支持方式的不同将76例鼻咽癌放疗患者分为肠内营养组(n=37)和肠外营养组(n=39)。所有患者均采用相同的放疗方案、放疗时间及常规干预,肠内营养组患者给予经鼻胃管肠内营养支持,肠外营养组患者给予肠外营养支持。比较两组患者的胃肠道功能指标[脂多糖(LPS)、二胺氧化酶(DAO)、D-乳酸、乳果糖/甘露醇(L/M)]、生活质量(生活质量评价量表)、负性情绪[汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)]、临床疗效及不良反应发生情况。结果 干预后,两组患者LPS、DAO、D-乳酸、L/M均高于本组干预前,肠外营养组患者LPS、DAO、D-乳酸、L/M均高于肠内营养组,差异均有统计学意义(P﹤0.05)。干预后,两组患者心理功能、躯体功能、社会功能、物质生活状态评分均高于本组干预前,肠外营养组患者心理功能、躯体功能、社会功能、物质生活状态评分均高于肠内营养组,差异均有统计学意义(P﹤0.05)。干预后,两组患者HAMA、HAMD评分均低于本组干预前,肠外营养组患者HAMA、HAMD评分均低于肠内营养组,差异均有统计学意义(P﹤0.05)。肠内营养组患者的总有效率高于肠外营养组(P﹤0.05)。肠外营养组患者恶心呕吐发生率高于肠内营养组,吞咽痛发生率低于肠内营养组,差异均有统计学意义(P﹤0.05)。结论 对于鼻咽癌放疗患者,肠内营养支持有助于胃肠道功能恢复,提高临床疗效,降低恶心呕吐发生率,而肠外营养支持有助于改善生活质量和负性情绪,降低吞咽痛发生率。

结直肠癌患者术后早期肠内营养支持的临床效果

目的探究结直肠患者术后及时给予早期肠内营养支持的临床效果。方法82例行结直肠癌手术的结直肠癌患者,依据随机数字表法分为观察组和对照组,每组41例。两组均在术后给予营养支持,对照组行肠外营养支持,观察组行早期肠内营养支持。对比两组的临床相关指标、营养状态指标、胃肠功能指标[生长抑素(SS)、血管活性肠肽(VIP)、胃泌素(GAS)、胃动素(MTL)]、炎性因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]及并发症发生率。结果观察组肛门首次排气时间(43.95±5.26)h、首次下床时间(40.37±7.92)h、住院天数(12.27±3.65)d均短于对照组的(58.87±6.94)h、(55.65±8.36)h、(14.86±4.06)d(P<0.05)。干预后,观察组前白蛋白、白蛋白、转铁蛋白水平分别为(267.47±19.94)mg/L、(39.18±4.95)g/L、(2.07±0.25)g/L,高于对照组的(244.23±18.58)mg/L、(35.47±3.45)g/L、(1.87±0.21)g/L(P<0.05)。干预后,观察组SS(47.87±4.54)ng/L低于对照组的(52.56±3.86)ng/L,GAS(118.34±15.74)ng/L、VIP(34.12±6.85)ng/L与MTL(66.31±10.22)ng/L高于对照组的(86.57±11.48)、(27.84±8.11)、(53.76±11.14)ng/L(P<0.05)。干预后,观察组TNF-α、IL-6与CRP水平分别为(182.38±14.43)ng/L、(254.28±33.76)ng/L、(9.32±1.85)mg/L,低于对照组的(238.94±25.51)ng/L、(336.57±34.52)ng/L、(11.89±2.68)mg/L(P<0.05)。观察组并发症发生率4.88%低于对照组的19.51%(χ^(2)=4.100,P=0.043<0.05)。结论针对结直肠癌患者,对其术后及时行早期肠内营养支持,可促进患者康复加速,改善营养状态、胃肠功能,同时有利于减轻炎症反应,控制并发症发生,价值突出。

重症急性胰腺炎行肠内营养病人动态腹内压监测预警分级标准及干预方案的构建

目的:构建重症急性胰腺炎(SAP)行肠内营养病人动态腹内压监测预警分级标准及干预方案。方法:检索国内外文献,拟定SAP行肠内营养病人动态腹内压监测预警分级标准及干预方案初稿。采用德尔菲专家函询法对专家进行2轮函询,形成SAP行肠内营养病人动态腹内压监测预警分级标准及干预方案。结果:2轮专家函询的问卷回收率均为100%,专家权威系数均为0.918,变异系数分别为0.077~0.156和0.056~0.167,肯德尔协调系数分别为0.353和0.331(P<0.001)。最终形成包含3项一级指标、13项二级指标、26项三级指标的SAP行肠内营养病人动态腹内压监测预警分级标准及干预方案。结论:本研究构建的SAP行肠内营养病人动态腹内压监测预警分级标准及干预方案具有一定的科学性和实用性,有利于指导临床实践。

基于营养耐受性分级护理策略的早期肠内营养支持在ICU脑出血患者中的应用

目的探讨给予重症监护室(ICU)脑出血患者基于营养耐受性分级护理策略的早期肠内营养支持的临床效果。方法选择徐州医科大学附属医院于2021年11月至2022年10月收治的100例脑出血患者为研究对象,并进行回顾分析,将这些患者按照护理方式的不同分成2组,每组50例。对照组给予早期肠内营养支持,观察组给予基于营养耐受性分级护理策略的早期肠内营养支持,护理周期为患者入院后1个月。比较2组患者的营养状况、免疫功能、病情、并发症发生率和治疗时间。结果干预28 d后,2组患者的血清总蛋白、血清前白蛋白和白蛋白水平,以及免疫球蛋白G、免疫球蛋白M和免疫球蛋白A水平均较入院时有所升高,且观察组均高于对照组,差异均有统计学意义(P均<0.05)。干预28 d后,2组患者的格拉斯哥昏迷量表(GCS)评分均较入院时有所升高,美国国立卫生研究院卒中量表(NIHSS)评分均较入院时有所降低,且观察组的GCS评分高于对照组,NIHSS评分低于对照组,以上差异均有统计学意义(P均<0.05)。观察组患者的并发症总发生率低于对照组,ICU入住时间和总住院时间均短于对照组(P均<0.05)。结论给予ICU脑出血患者基于营养耐受性分级护理策略的早期肠内营养支持,能够改善患者的营养状况和免疫功能,缓解其病情,且能缩短治疗时间,降低并发症发生率。

风险预警护理对脑卒中住院肠内营养支持患者营养状况及预后的影响

目的探讨风险预警护理对脑卒中住院肠内营养支持患者营养状况及预后的影响。方法选取2020年2月至2022年5月期间上海市第八人民医院收治的100例脑卒中患者进行研究,按随机数表法分为观察组和对照组各50例。两组患者均接受肠内营养支持治疗,对照组患者给予常规护理,观察组患者在对照组常规护理基础上结合风险预警护理。护理至患者出院时,比较两组患者肠鸣音恢复、排气及排便时间,同时比较两组患者护理前及出院时的营养指标[血清白蛋白(ALB)、前白蛋白(PA)、总蛋白(TP)]、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]指标及神经功能评分量表(NIHSS)评分,统计两组患者治疗期间的不良反应发生情况。结果观察组患者的肠鸣音恢复时间、肛门排气时间、排便时间分别为(2.81±0.51)h、(38.19±3.51)h、(78.26±4.28)h,明显短于对照组的(3.28±0.47)h、(47.27±4.82)h、(89.10±5.19)h,差异均有统计学意义(P<0.05);护理后,两组患者的ALB、PA、TP均升高,且观察组的ALB、PA、TP分别为(52.10±4.06)mg/mL、(391.18±21.05)μg/mL、(73.10±4.84)mg/mL,明显高于对照组的(44.28±4.28)mg/mL、(341.28±20.98)μg/mL、(763.17±5.21)mg/mL,差异均有统计学意义(P<0.05);护理后,两组患者的SAS、SDS及NIHSS评分均降低,观察组患者的SAS、SDS、NIHSS分别为(30.28±3.21)分、(31.34±2.04)分、(6.28±1.16)分,明显低于对照组的(38.31±2.94)分、(37.31±2.37)分、(8.27±1.78)分,差异均有统计学意义(P<0.05);观察组患者治疗期间的并发症发生率为4.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论风险预警护理可有效促进脑卒中住院肠内营养支持患者的胃肠功能恢复,改善营养状态,调节心理状态,有益于神经功能恢复,降低并发症,可在临床推广应用。

聚焦模式及营养支持在老年髋部骨折中的应用

目的探讨老年髋部骨折患者应用聚焦解决干预模式联合早期营养支持的效果。方法选择2020年1月至2021年12月老年髋部骨折患者100例,按随机数字表法分为2组,各50例。对照组在围术期实施常规护理干预,观察组在围术期常规护理基础上应用聚焦解决模式联合早期营养支持。比较两组治疗依从性、护理满意度、营养指标、心理评分、睡眠质量、生活质量评分。结果与对照组比较,观察组围术期总依从率更高,观察组术后第3天对疼痛评分更低;且在护理后,观察组血红蛋白、白蛋白均更高;观察组在心理、睡眠质量评分均更低,观察组在生活质量四个维度评分更高,观察组在总满意率更高,差异均有统计学意义(P<0.05)。结论在老年髋部骨折患者围术期护理中,聚焦解决模式联合早期营养支持干预可增强患者的依从性,改善其营养状况,并对于患者心理不良情绪予以消除,对夜间睡眠和生活质量起到改善作用,患者对护理治疗更满意。

渐进式早期康复训练联合早期肠内营养支持对重症急性胰腺炎患者的干预效果观察

目的探讨渐进式早期康复训练联合早期肠内营养支持对重症急性胰腺炎(SAP)患者的干预效果。方法120例SAP患者,按照随机数字表法分为对照组和观察组,每组60例。对照组予以常规护理,观察组实施渐进式早期康复训练联合早期肠内营养支持干预。比较两组患者症状改善情况以及干预前后营养状况、炎性因子、生活质量。结果观察组排便恢复时间(3.71±0.68)d、排气恢复时间(3.62±0.77)d、腹痛和腹胀改善时间(3.31±0.48)d、肠鸣音恢复时间(4.11±0.63)d均短于对照组的(4.33±1.16)、(4.35±1.03)、(3.97±0.92)、(4.82±0.92)d(P<0.05)。干预后,两组转铁蛋白、前白蛋白、白蛋白、血红蛋白均高于干预前,且观察组转铁蛋白(2.61±0.54)g/L、前白蛋白(0.30±0.09)g/L、白蛋白(48.77±4.03)g/L、血红蛋白(119.26±4.05)g/L均高于对照组的(2.03±0.45)、(0.25±0.06)、(39.22±3.76)、(112.02±3.72)g/L(P<0.05)。干预后,两组白细胞介素10(IL-10)高于干预前,C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)均低于干预前,且观察组IL-10(15.61±3.72)pg/ml高于对照组的(10.26±3.29)pg/ml,CRP(19.87±1.07)mg/L、TNF-α(12.77±2.15)pg/ml、IL-6(11.51±2.01)pg/ml均低于对照组的(62.77±1.52)mg/L、(59.77±4.13)pg/ml、(21.33±2.74)pg/ml(P<0.05)。干预后,两组社会功能、生理功能、心理功能、物质生活评分均高于对照组,且观察组社会功能评分(69.77±4.51)分、生理功能评分(62.79±5.61)分、心理功能评分(70.28±4.76)分、物质生活评分(60.55±5.72)分均高于对照组的(56.83±3.05)、(50.24±4.13)、(56.55±3.84)、(49.32±2.63)分(P<0.05)。结论将渐进式早期康复训练联合早期肠内营养支持应用于SAP患者的治疗中效果较好,能够调节机体炎性水平,加快症状改善,提升机体营养水平,提高生活质量。

早期肠内、外营养支持在新生儿缺氧缺血性脑病中的应用效果及对NBNA评分的影响

目的探讨早期肠内、外营养支持在新生儿缺氧缺血性脑病(HIE)中的应用效果及对新生儿行为神经测定(NBNA)评分的影响。方法选择2016年1月至2021年12月收治的124例HIE患儿为研究对象,按照随机数字表法将其分为对照组和研究组,各62例。对照组接受肠外营养支持治疗,研究组接受肠内+肠外营养支持治疗。比较两组的治疗效果。结果研究组的经口摄入时间、达基础热卡时间以及住院时间短于对照组,治疗15 d体质量增长值高于对照组(P<0.05)。治疗后,研究组的间接胆红素、直接胆红素水平低于对照组,氯离子、钙离子水平高于对照组(P<0.05)。治疗后,研究组的8-羟基脱氧鸟苷(8-OHdG)、神经元特异性烯醇化酶(NSE)、可溶性白细胞介素2受体(sIL-2R)水平低于对照组,胰岛素样生长因子-1(IGF-1)、白细胞介素-2(IL-2)水平高于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。治疗5、10、15 d后,研究组的NBNA评分高于对照组(P<0.05)。结论将早期肠内、外营养支持治疗方案应用于HIE治疗中,能够缩短患儿住院治疗时间,有助于促进病情转归,对改善预后具有积极意义。

肠内外营养支持对结直肠癌化疗患者的作用分析

目的 观察在结直肠癌化疗患者中采取肠内外营养支持的有效性。方法 非随机选取2021年1月—2024年5月广西中医药大学附属瑞康医院收治的80例结直肠癌化疗患者作为研究对象,按治疗方法不同分为两组,各40例。观察组采取肠内外营养支持,对照组采取肠外营养支持。对比两组患者症状积分、营养状况、免疫功能、癌因性疲乏程度及不良反应。结果 干预后,观察组症状积分、营养状况、免疫功能及癌因性疲乏程度均优于对照组,差异有统计学意义(P均<0.05);观察组不良反应发生率为2.50%(1/40),低于对照组的15.00%(6/40),差异有统计学意义(χ^(2)=3.914,P<0.05)。结论 在结直肠癌化疗患者中采取肠内外营养支持具备重要临床意义,能够改善不适症状,优化营养状况,还能够增强免疫功能,降低癌因性疲乏程度,减少不良反应。

人文护理联合肠内营养支持的集束化护理对低出生体质量先天性心脏病手术患儿的影响

目的:探讨人文护理联合肠内营养支持下集束化护理对低出生体质量先天性心脏病手术患儿的影响。方法:选取2020年3月—2023年3月喀什地区第一人民医院收治的低出生体质量先天性心脏病并行手术治疗的患儿100例为研究对象,按随机数字表法分成观察组与对照组,各50例。对照组予以常规护理,观察组在对照组基础上给予人文关怀联合肠内营养支持的集束化护理。比较两组患儿干预前后的白蛋白、前白蛋白、总蛋白水平以及舒适度。结果:干预4周后,两组白蛋白、前白蛋白、总蛋白水平均升高,观察组高于对照组,差异有统计学意义(P<0.05);观察组舒适度高于对照组,差异有统计学意义(P=0.014)。结论:针对低出生体质量的先天性心脏病手术患儿,应用手术护理联合肠内营养支持的集束化护理干预措施,可以显著改善患儿的白蛋白、前白蛋白、总蛋白水平,提高患儿舒适度。