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评估围手术期营养教育对改善食管切除术后口服摄入的作用:一项回顾性研究。

Assessing the Role of Perioperative Nutritional Education in Improving Oral Intake after Oesophagectomy: A Retrospective Study.

机构信息

Department of Foods and Human Nutrition Faculty of Human Life Sciences, Notre Dame Seishin University, Okayama, Japan.

Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

出版信息

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2037-2041. doi: 10.31557/APJCP.2023.24.6.2037.

Abstract

BACKGROUND

This study aimed to determine whether nutritional education, from the preoperative to postoperative period, and nutritional management designed to improve nutritional status alone, could improve patients' health-related self-management and nutritional management skills during the postoperative period.

METHODS

We evaluated 101 hospitalised patients with oesophageal cancer who underwent surgery between 2015 and 2016 and received perioperative nutritional education (PERIO-N). The control group included 52 patients who underwent surgery between 2014 and 2015 and were supported only by normal interventions according to the Enhanced Recovery After Surgery protocol. The PERIO-N group paid specific attention to nutrition risk screening, nutrition assessment, nutrition monitoring, and lifestyle education.

RESULTS

The patients in the PERIO-N group were 1.8 times more likely to be able to consume food orally than the control group (p=0.010). In the PERIO-N group, 50.5% of the patients could orally consume food, 42.6% received a combination of oral and enteral nutrition, and 6.9% only underwent enteral nutrition. In comparison, in the control group, 28.8% of the patients could orally consume food, 53.8% received a combination of oral and enteral nutrition, and 17.3% were only administered enteral nutrition (p=0.004). In addition, patients in the PERIO-N group were discharged at a 1.5 times higher rate than those in the control group (p=0.027). The readmission rate for malnutrition within 3 months was 4% in the PERIO group (5.4% for home discharge only) and 5.8% in the control group (10.5% for home discharge only) (p=0.61).

CONCLUSION

This study found that perioperative nutrition education in patients who underwent oesophageal cancer surgery led to increase in the amount of oral intake at discharge. Moreover, the group that received nutrition education did not have an increased probability of hospitalisation due to the risk of malnutrition within 3 months after discharge.

摘要

背景

本研究旨在确定从术前到术后的营养教育以及旨在改善营养状况的营养管理是否可以提高患者在术后期间的健康相关自我管理和营养管理技能。

方法

我们评估了 2015 年至 2016 年间接受手术的 101 名食管癌住院患者,并对其进行了围手术期营养教育(PERIO-N)。对照组包括 52 名在 2014 年至 2015 年间接受手术且仅根据加速康复外科方案接受常规干预的患者。PERIO-N 组特别注意营养风险筛查、营养评估、营养监测和生活方式教育。

结果

PERIO-N 组患者能够经口进食的可能性是对照组的 1.8 倍(p=0.010)。在 PERIO-N 组中,50.5%的患者能够经口进食,42.6%的患者接受口服和肠内营养联合治疗,6.9%的患者仅接受肠内营养。相比之下,在对照组中,28.8%的患者能够经口进食,53.8%的患者接受口服和肠内营养联合治疗,17.3%的患者仅接受肠内营养(p=0.004)。此外,PERIO-N 组患者的出院率是对照组的 1.5 倍(p=0.027)。PERIO-N 组术后 3 个月内因营养不良再入院的比例为 4%(仅出院回家者为 5.4%),对照组为 5.8%(仅出院回家者为 10.5%)(p=0.61)。

结论

本研究发现,食管癌手术患者的围手术期营养教育可增加出院时的口服摄入量。此外,接受营养教育的组在出院后 3 个月内因营养不良风险住院的可能性并没有增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c63/10505890/e030718ddd3a/APJCP-24-2037-g001.jpg

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