| 摘要: |
| 目的 观察个体化家庭肠内营养支持对食管癌根治术后管饲患者的BMI、营养不良发生情况、术后体重下降及营养相关指标的影响。方法 选择上海交通大学附属胸科医院2018-2019年收治的食管癌根治术后家庭肠内营养管饲患者作为研究对象，其中2018年1-12月收治的136例接受常规家庭肠内营养宣教的患者为对照组，2019年1-12月收治的146例接受常规家庭肠内营养宣教+个体化营养食谱干预的患者为干预组。比较两组患者在营养干预前后体重、BMI、营养不良发生率、体重丢失情况及营养相关指标的变化。结果 出院时，对照组和干预组体重、BMI和营养不良发生率差异均无统计学意义（P均>0.05），但干预组营养相关指标中总蛋白、白蛋白、淋巴细胞计数均低于对照组，差异均有统计学意义（P均<0.05）。在营养干预3周后，干预组体重、BMI与对照组相比差异均无统计学意义（P均>0.05）；干预组营养不良发生率（17.8%，26/146）低于对照组（27.9%，38/136），差异有统计学意义（P<0.05）；干预组体重丢失值和BMI变化值均低于对照组，差异均有统计学意义（P均<0.001）；干预组营养相关指标中总蛋白、前白蛋白均高于对照组，差异均有统计学意义（P均<0.05）。结论 个体化全程营养指导方式下的家庭肠内营养支持可预防食管癌根治术后管饲患者的体重丢失，降低术后营养不良发生风险，改善术后营养状况。 |
| 关键词: 家庭肠内营养 食管肿瘤 管饲 体重丢失 营养不良 |
| DOI：10.16781/j.0258-879x.2021.11.1246 |
| 投稿时间：2021-06-09修订日期：2021-10-26 |
| 基金项目: |
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| Effects of individualized home enteral nutrition support on postoperative nutritional management of patients with esophageal cancer |
| SUN Yan1,LIU Jian-jun1,YU Xiao-yan1,ZHOU Hui-hui1,WU Hui-wen1,LI Zhi-gang2* |
(1. Department of Nutrition, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China;
2. Section of Esophageal Surgery, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
*Corresponding author) |
| Abstract: |
| Objective To observe the effects of individualized home enteral nutrition support on body mass index (BMI), incidence of malnutrition, postoperative body weight loss and nutritional indexes in patients on tube feeding after radical esophagectomy. Methods Patients on home enteral nutrition tube feeding after radical esophagectomy treated in Shanghai Chest Hospital, Shanghai Jiao Tong University from 2018 to 2019 were selected, including 136 patients who received routine home enteral nutrition education from Jan. to Dec. 2018 (control group) and 146 patients who received routine home enteral nutrition education+individualized nutrition diet intervention from Jan. to Dec. 2019 (intervention group). The changes in body weight, BMI, incidence of malnutrition, weight loss and nutritional indexes were compared between the 2 groups before and after nutrition intervention. Results There were no significant differences in weight, BMI or incidence of malnutrition between the 2 groups at discharge (all P>0.05). However, the nutritional indexes (total protein, albumin and lymphocyte count) of the intervention group were significantly lower than those of the control group (all P<0.05). After 3 weeks of nutrition intervention, there was no significant difference in body weight or BMI between the 2 groups (both P>0.05); the incidence of malnutrition of the intervention group was significantly lower than that of the control group (17.8%[26/146]vs 27.9%[38/136], P<0.05); the changes of body weight loss and BMI of the intervention group were significantly lower than those of the control group (both P<0.001); and the total protein and prealbumin levels were significantly higher than those of the control group (both P<0.05). Conclusion Home enteral nutrition support combined with individualized whole-course nutrition guidance can significantly prevent postoperative body weight loss, reduce the risk of postoperative malnutrition and improve postoperative nutritional status in patients on tube feeding after esophageal cancer surgery. |
| Key words: home enteral nutrition esophageal neoplasms tube feeding body weight loss malnutrition |
