圍手術(shù)期同步營養(yǎng)干預(yù)對直腸癌術(shù)后炎性反應(yīng)和預(yù)后的影響

晁昳

摘要目的：探討直腸癌圍手術(shù)期實(shí)行同步營養(yǎng)干預(yù)對患者炎性反應(yīng)和預(yù)后的影響。方法：收治直腸癌患者85例，分為兩組。觀察組實(shí)施同步營養(yǎng)干預(yù)，對照組采用常規(guī)圍手術(shù)期飲食護(hù)理，比較兩組術(shù)后炎性反應(yīng)、切口愈合情況。結(jié)果：兩組術(shù)后CRP、SAA均明顯升高，術(shù)后3d觀察組患者CRP、SAA水平上升幅度明顯低于對照組，術(shù)后7d均有所下降，但仍高于正常值，觀察組CRP、SAA濃度下降更快（P<0.05）;觀察組患者術(shù)后腸功能恢復(fù)時(shí)間、術(shù)后補(bǔ)液治療時(shí)間均明顯低于對照組（P<0.05）;且觀察組患者在術(shù)后均未發(fā)生切口感染、脂肪液化，明顯低于對照組（P<（0.05）。結(jié)論：直腸癌圍手術(shù)期實(shí)施同步營養(yǎng)干預(yù)可降低術(shù)后炎性反應(yīng)，表明科學(xué)的營養(yǎng)干預(yù)能有效促進(jìn)患者早日康復(fù)。

關(guān)鍵詞 直腸癌;圍手術(shù)期;營養(yǎng)干預(yù);炎性反應(yīng)

Effect of perioperative simultaneous nutritional intervention on postoperative inflammatory response and prognosis ofrectal canceChao Yi

Abstract Objective：To investigate the effect of synchronous nutritional intervention on inflammatory response and prognosis ofpatients with rectal cancer during perioperative period.Methods：85 patients with rectal cancer were divided into the two groups.The observation group was given simultaneous nutrition intervention，the control group was given routine perioperative diet nursing，and the inflammatory reaction and wound healing situation were compared between the two groups.Results：CRP and SAAincreased significantly in both groups after operation.The level of CRP.SAA in the observation group was significantly lower thanthat in the control group on the 3rd day after operation.The decrease was still higher than the normal value on the 7th day afteroperation.The CRP and SAA concentrations in the observation group decreased fascer（P<0.05）.The recovery time of intestinalfunction and the time of rehytration in the ohservation group were significancly lower than those in the control group（P<0.05）.There was no incision infection and fat liquefaction in the observation group，which was significantly lower than that in the controlgroup（P< 0.05）.Conclusion：Synchronized nutritional intervention cluring perioperative period of rec.tal c：ancer c.an reduc.e theinflammacory reaction after operation.which indicates that scientific. nutritional intervention can effectively promote the earlyrecovery of patients.

Key words

Rectal cancer;Perioperative surgery;Nucricional intervention：lnflammatory response

臨床上，許多胃腸道疾病患者由于疾病的原因，存在一定程度的營養(yǎng)不良。研究表明，營養(yǎng)不良將大大增加手術(shù)風(fēng)險(xiǎn)，術(shù)后并發(fā)癥的發(fā)生率及病死率高于營養(yǎng)正常者[1]。對于圍于術(shù)期給予營養(yǎng)支持，能有效改善患者的營養(yǎng)水平，減少術(shù)后并發(fā)癥的發(fā)生[2，3]。由于直腸癌患者更容易發(fā)牛能量攝入不足，營養(yǎng)及代謝明顯失衡，阻礙術(shù)后恢復(fù)。因此，營養(yǎng)狀況好壞對于能否達(dá)到手術(shù)效果和改善預(yù)后有重要意義。為探討圍手術(shù)期直腸癌患者同步營養(yǎng)干預(yù)措施，2015年1-8月收治直腸癌患者44例，在圍手術(shù)期間進(jìn)行同步營養(yǎng)干預(yù)，均取得良好效果，現(xiàn)報(bào)告如下。

資料與方法

2015年1-8月收治直腸癌患者85例。（l）納入標(biāo)準(zhǔn)：①年齡>18歲;②符合國際抗癌聯(lián)盟TNM系統(tǒng)第6版（2002年）直腸癌診斷標(biāo)準(zhǔn);③均行腹腔鏡手術(shù);④擇期手術(shù);意識清楚，具有一定表達(dá)能力;⑤自愿參與本研究。（2）排除標(biāo)準(zhǔn)：①既往其他嚴(yán)重軀體疾病者;②急診手術(shù);③經(jīng)口進(jìn)食困難患者。將符合納入標(biāo)準(zhǔn)患者分為觀察組（44例）和對照組（41例）。對……