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一项评估口腔癌患者术后营养干预的前瞻性随机对照试验。

A prospective randomized comparative trial evaluating postoperative nutritional intervention in patients with oral cancer.

机构信息

Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.

Medical Clinic III - Department of Gastroenterology, Metabolic Disorders and Internal Intensive Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.

出版信息

Sci Rep. 2022 Aug 20;12(1):14213. doi: 10.1038/s41598-022-18292-8.

Abstract

Extensive surgical treatment of oral cancer results in significant deterioration of nutritional status with concomitant increased nutrient requirements. The consequences are an elevated risk of postoperative complaints as well as morbidity and mortality. The aim of this study was to investigate an additional postoperative nutritional intervention through professional nutritional advice and nutritional supplementation in patients with oral cancer for at least six months. 62 patients with oral cancer in the department of oral and maxillofacial surgery were randomized into two groups. The intervention group received nutritional supplements, protein-rich, high-fiber diet and care by a professional nutritionist in addition to the standard treatment. The control group received only the standard treatment. Statistical analysis includes the evaluation of means and standard deviations as well as the calculation of p values with a significance level of 0.05. A deficiency of protein, albumin, vitamin D, zinc and iron was noticed in both groups immediately after surgery. Patients in the intervention group recorded significantly less weight loss (pT2 = 0.0031, pT4 = 0.0424), a more stable BMI (pT2 = 0.0496), better values for albumin (pT2 = 0.0265), vitamin A (pT3 = 0.0248, pT4 = 0.0007) and calcium (pT3 = 0.0362) during the follow-ups. The patients in the intervention group showed significantly fewer digestive problems (p = 0.0062) and muscular complaints (p = 0.0448). They showed better eating habits (p = 0.0348) and were capable of more physical activity (p = 0.0045) than patients in the control group. Patients with oral cancer can have a benefit from postoperative nutritional intervention. Early screening, appropriate care by a nutritionist and supplementation with vitamin D, zinc, calcium and protein-rich food are recommended.

摘要

口腔癌的广泛手术治疗会导致营养状况显著恶化,并伴有更高的营养需求。其结果是术后并发症的风险增加,发病率和死亡率也随之升高。本研究旨在探讨对口腔癌患者进行至少 6 个月的术后营养干预,包括专业的营养咨询和营养补充。在口腔颌面外科部门,将 62 名口腔癌患者随机分为两组。干预组除接受标准治疗外,还接受营养补充剂、高蛋白、高纤维饮食和专业营养师的护理。对照组仅接受标准治疗。统计分析包括均值和标准差的评估以及 p 值的计算,显著性水平为 0.05。两组患者术后均出现蛋白质、白蛋白、维生素 D、锌和铁缺乏。干预组患者的体重减轻明显较少(pT2 = 0.0031,pT4 = 0.0424),BMI 更稳定(pT2 = 0.0496),白蛋白(pT2 = 0.0265)、维生素 A(pT3 = 0.0248,pT4 = 0.0007)和钙(pT3 = 0.0362)的值在随访期间也更好。干预组患者的消化问题(p = 0.0062)和肌肉问题(p = 0.0448)明显较少。他们的饮食习惯更好(p = 0.0348),体力活动能力更强(p = 0.0045),优于对照组患者。术后营养干预对口腔癌患者有益。建议早期筛查、营养师的适当护理以及补充维生素 D、锌、钙和高蛋白食物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd58/9392772/b43d7aefaba1/41598_2022_18292_Fig1_HTML.jpg

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