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术后肠内营养支持护理联合早期经口进食对喉癌患者术后疗效及咽瘘愈合的分析

Analysis of post-operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post-operative enteral nutrition support nursing combined with early oral feeding.

作者信息

Lin Aitao, Ye Jin, Wang Zhiyuan, Li Pei

机构信息

Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510630, P.R. China.

出版信息

Oncol Lett. 2020 Jun;19(6):3964-3970. doi: 10.3892/ol.2020.11503. Epub 2020 Apr 1.

Abstract

The present study aimed to analyze the effects of post-operative enteral nutrition support nursing combined with early oral feeding on post-operative efficacy and pharyngeal fistula (PF) healing in patients with laryngeal cancer (LC). A retrospective analysis of 133 patients with LC, who underwent laryngectomy between May 2014 and September 2016, was conducted. Of these patients, 61 patients (control group) were treated with enteral nutrition support nursing combined with nasogastric feeding, and 72 patients (observation group) were treated with enteral nutrition support nursing combined with early oral feeding. Levels of serum albumin (ALB), pre-albumin (PA), hemoglobin (Hb) and the lymphocyte count (LYM) were compared before and after surgery (7 and 14th post-operative days). The post-operative weight, upper arm muscle circumference (UAMC), triceps skinfold (TSF), post-operative infection, adverse reactions and PF healing were also measured. No differences were observed between the control and observation groups before surgery (all P>0.05). ALB, Hb, PA and LYM were significantly decreased in the control group on the 7 and 14th days post-operatively compared with those in the observation group (all P<0.05). Five patients in the control group presented with PF during treatment, and seven patients in the observation group suffered from PF after surgery. No difference in the average healing time of PF, number of patients with post-operative infection and adverse reactions were observed between the two groups (all P>0.05). The weight and UAMC in the observation group, 14 days post-operatively, were significantly higher than those before surgery in the same patients and in the control group (all P<0.05), whereas no difference in TSF (P>0.05) was observed. No differences in weight, UAMC and TSF were revealed in the control group before surgery and on the 14th day post-operatively (all P>0.05). Thus, post-operative enteral nutrition support nursing combined with early oral feeding resulted in significant improvement in the post-operative efficacy of patients with LC and had no effect on PF healing.

摘要

本研究旨在分析术后肠内营养支持护理联合早期经口进食对喉癌(LC)患者术后疗效及咽瘘(PF)愈合的影响。对2014年5月至2016年9月期间接受喉切除术的133例LC患者进行回顾性分析。其中,61例患者(对照组)接受肠内营养支持护理联合鼻饲喂养,72例患者(观察组)接受肠内营养支持护理联合早期经口进食。比较手术前后(术后7天和14天)血清白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)和淋巴细胞计数(LYM)水平。还测量了术后体重、上臂肌肉周长(UAMC)、肱三头肌皮褶厚度(TSF)、术后感染、不良反应及PF愈合情况。术前对照组和观察组之间未观察到差异(所有P>0.05)。与观察组相比,对照组术后第7天和第14天的ALB、Hb、PA和LYM显著降低(所有P<0.05)。对照组有5例患者在治疗期间出现PF,观察组有7例患者术后发生PF。两组之间PF的平均愈合时间、术后感染患者数量及不良反应方面未观察到差异(所有P>0.05)。观察组术后14天的体重和UAMC显著高于同一患者术前及对照组(所有P<0.05),而TSF无差异(P>0.05)。对照组术前和术后第14天的体重、UAMC和TSF无差异(所有P>0.05)。因此,术后肠内营养支持护理联合早期经口进食可显著改善LC患者的术后疗效,且对PF愈合无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80f1/7202300/a399ebdc0e27/ol-19-06-3964-g00.jpg

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