Chen Zhi, Hong Bo, He Jiang-Juan, Ye Qian-Qian, Hu Qiao-Yi
Department of Rehabilitation, Xiangshan First People's Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China.
Department of Gastroenterology, Xiangshan First People's Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China.
World J Gastrointest Surg. 2023 Oct 27;15(10):2222-2233. doi: 10.4240/wjgs.v15.i10.2222.
Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment. Surgery is the main treatment for these patients, but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction, leading to further deterioration of the nutritional status. Early enteral nutrition support is hypothesized to be helpful in improving this situation, but the exact effects have yet to be studied in depth.
To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors, with the expectation that by improving the nutritional status of patients, the recovery process would be accelerated and the incidence of complications would be reduced, thus improving the quality of life.
A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed. Fifty-three of these patients received complete parenteral nutrition support as the control group for this study. The other 68 patients received early enteral nutritional support as the observation group of this study. The clinical indicators comparing the two groups included time to fever, time to recovery of postoperative bowel function, time to postoperative exhaustion, and length of hospital stay. The changes in immune function and nutritional indexes in the two groups were compared. Furthermore, we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients. Finally, the occurrence of postoperative complications between the two patient groups was also compared.
The postoperative fever time, postoperative bowel function recovery time, postoperative exhaustion time, and hospitalization time were all higher in the control group than in the observation group ( < 0.05). The levels of CD3+, CD4+, immunoglobulin (Ig) A, IgM, and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively, while CD8+ was lower than in the control group ( < 0.05). Total protein, albumin, prealbumin, and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively ( < 0.05). The SF-36 scores of patients in the observation group were significantly higher than those in the control group ( < 0.0001). The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group ( = 0.021).
We found that patients with gastrointestinal tumors are nutritionally vulnerable, and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery. This program can not only improve the immune function of the patient and protect the intestinal function, but it can also help to improve the quality of life of the patient. However, this program will increase the incidence of complications in patients. Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer. The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.
胃肠道肿瘤患者在治疗期间常伴有营养状况不佳。手术是这些患者的主要治疗方式，但术后较长的恢复期常伴有消化和吸收功能障碍，导致营养状况进一步恶化。早期肠内营养支持被认为有助于改善这种情况，但其确切效果仍有待深入研究。
观察早期肠内营养支持对接受手术治疗的胃肠道肿瘤患者术后恢复的影响，期望通过改善患者营养状况，加速恢复进程，降低并发症发生率，从而提高生活质量。
对2020年1月至2023年1月在我院接受治疗的121例胃肠道肿瘤患者进行回顾性分析。其中53例患者接受完全肠外营养支持作为本研究的对照组。另外68例患者接受早期肠内营养支持作为本研究的观察组。比较两组的临床指标包括发热时间、术后肠功能恢复时间、术后疲惫时间和住院时间。比较两组免疫功能和营养指标的变化。此外，我们使用SF - 36量表比较两组患者生活质量的变化。最后，比较两组患者术后并发症的发生情况。
对照组术后发热时间、术后肠功能恢复时间、术后疲惫时间和住院时间均高于观察组（<0.05）。术后1天和7天，观察组CD3 +、CD4 +、免疫球蛋白（Ig）A、IgM和IgG水平显著高于对照组，而CD8 +低于对照组（<0.05）。术后7天，观察组总蛋白、白蛋白、前白蛋白和转铁蛋白水平显著高于对照组（<0.05）。观察组患者的SF - 36评分显著高于对照组（<0.0001）。干预后对照组不良反应总发生率显著低于观察组（= = 0.021）。
我们发现胃肠道肿瘤患者营养状况脆弱，早期肠内营养支持方案可改善患者营养状况并加速术后恢复。该方案不仅可提高患者免疫功能、保护肠道功能，还有助于提高患者生活质量。然而，该方案会增加患者并发症发生率。对胃癌患者采取早期肠内营养支持措施时应谨慎。应全面评估患者病情和身体状况并密切监测，以预防可能的并发症。
