Department of Clinical Nutrition, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing, China.
Orthopedics Department, Beijing Chest Hospital Affiliated to Capital Medical University, Beijing, China.
Asia Pac J Clin Nutr. 2024 Mar;33(1):39-46. doi: 10.6133/apjcn.202403_34(1).0005.
To explore the effect of nutrition management under ERAS concept in patients with spinal tuberculosis.
The study was conducted in an orthopedic ward of a tertiary grade A special hospital in Beijing. The patients admitted from January 1, 2021 to June 27, 2023 were screened for inclusion. The qualified patients were randomized into experimental group or control group. The experimental group received perioperative nutrition management under the concept of ERAS while the control group received routine perioperative management in hospital. The data was collected on the next day of admission, the next day and the sixth day after operation, including laboratory indicators (lymphocyte count, hemoglobin level, etc), intraoperative bleeding volume, postoperative exhaust, defecation time, drainage volume, albumin infusion amount, nutritional risk score, length of stay, hospitalization costs, etc. Univariate analysis and multivariate analysis correcting for gender, age, and baseline values were performed using SPSS24.0.
A total of 127 patients with spinal tuberculosis completed the study. Compared with the control group, the intraoperative blood loss (p=0.028) in the experimental group was significantly reduced, the postoperative exhaust time (p=0.012) and defecation time (p=0.012) were significantly shortened, and the nutritional status (p<0.001) was significantly improved. Besides, the results of multivariate analysis are robust after correcting potential confounding factors.
Nutrition management under the concept of ERAS is helpful to reduce intraoperative bleeding, promote postoperative flatus and defecation, and improve nutritional status in patients with spinal tuberculosis, which may further improve their clinical outcome and prognosis.
探讨加速康复外科(ERAS)理念下的营养管理对脊柱结核患者的影响。
本研究在北京一家三级甲等专科医院的骨科病房进行。筛选 2021 年 1 月 1 日至 2023 年 6 月 27 日入院的患者。合格患者随机分为实验组或对照组。实验组接受 ERAS 理念下的围手术期营养管理,对照组接受常规围手术期院内管理。收集入院后第 1 天、第 2 天和第 6 天的实验室指标(淋巴细胞计数、血红蛋白水平等)、术中出血量、术后排气、排便时间、引流液量、白蛋白输注量、营养风险评分、住院时间、住院费用等数据。使用 SPSS24.0 进行单因素分析和多因素分析,校正性别、年龄和基线值。
共 127 例脊柱结核患者完成研究。与对照组相比,实验组术中出血量(p=0.028)显著减少,术后排气时间(p=0.012)和排便时间(p=0.012)显著缩短,营养状况(p<0.001)显著改善。此外,校正潜在混杂因素后,多因素分析结果稳健。
ERAS 理念下的营养管理有助于减少脊柱结核患者的术中出血,促进术后排气和排便,改善营养状况,从而可能进一步改善其临床结局和预后。