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各种营养干预措施对口腔颌面部肿瘤手术患者身心状态的影响:指导患者做出知情选择。

Impact of various nutritional interventions on the physical and mental state of patients undergoing surgery for oral and maxillofacial tumor: guiding patients' informed choices.

机构信息

Institute of Sport, Exercise and Health, Tianjin University of Sport, No.16 Donghai Road, West Tuanbo New Town, Jinghai District, Tianjin, 300381, China.

Department of Nutrition, Tianjin Stomatological Hospital, No. 75 Dagu Road, Heping District, Tianjin, 300041, China.

出版信息

Support Care Cancer. 2024 Jul 31;32(8):559. doi: 10.1007/s00520-024-08748-0.

Abstract

PURPOSE

To compare the effects of oral nutritional supplements (ONS), parenteral nutrition (PN), and enteral nutrition (EN) on the recovery of patients who underwent oral and maxillofacial surgery.

METHODS

The shared decision-making process assigned 37, 56, and 35 patients to the ONS, PN, and EN groups, respectively. Details such as demographic data, duration of hospitalization, cost of nutritional therapy, nutritional assessments, patients' satisfaction, and compliance, Hamilton Anxiety Rating Scale (HAM-A) score, and relevant biochemical indices were systematically recorded and compared between the groups.

RESULTS

Patients with healthier biochemical indices and physical states at baseline, including a higher body mass index, preferred ONS. Patients using dentures and those with medical insurance often chose EN, while patients with recurrent disease preferred PN. Patients receiving EN had a similar duration of hospitalization to patients receiving ONS and also had the lowest nutritional costs. Patients receiving ONS had higher lymphocyte counts and levels of hemoglobin, albumin, and C-reactive protein. Patients in the PN group had elevated levels of serum potassium, chlorine, and sodium, while those receiving EN reported higher HAM-A scores, indicating greater anxiety than their counterparts. Predischarge surveys showed higher satisfaction and compliance in the PN and ONS groups than in the EN group. The PN group reported more adverse symptoms. At 7 days post-discharge, patients with EN reported a greater feeling of well-being.

CONCLUSION

ONS is the optimal choice for patients in good preoperative conditions, while PN is preferred during disease recurrence or when financially feasible. EN is suitable for patients using dentures or those with limited finances despite its potential psychological discomfort. Future studies with increased sample sizes and longer follow-up duration are necessary to corroborate our findings. The Trial Registration Number is ChiCTR2100049547. The date of registration is August 2, 2021.

摘要

目的

比较口服营养补充剂(ONS)、肠外营养(PN)和肠内营养(EN)对口腔颌面外科患者康复的影响。

方法

采用共享决策模式将 37、56 和 35 例患者分别分配到 ONS、PN 和 EN 组。系统记录和比较了各组之间的人口统计学数据、住院时间、营养治疗费用、营养评估、患者满意度和依从性、汉密尔顿焦虑量表(HAM-A)评分以及相关生化指标等详细信息。

结果

基线时具有更健康的生化指标和身体状况的患者,包括更高的体重指数,更喜欢 ONS。使用假牙和有医疗保险的患者常选择 EN,而有复发性疾病的患者则喜欢 PN。接受 EN 的患者与接受 ONS 的患者住院时间相似,且营养费用最低。接受 ONS 的患者淋巴细胞计数和血红蛋白、白蛋白和 C 反应蛋白水平较高。PN 组患者血清钾、氯和钠水平升高,而接受 EN 的患者 HAM-A 评分较高,表明焦虑程度高于对照组。出院前调查显示,PN 和 ONS 组的满意度和依从性均高于 EN 组。PN 组报告的不良反应更多。出院后 7 天,接受 EN 的患者感觉更舒适。

结论

ONS 是术前条件良好患者的最佳选择,而在疾病复发或经济可行时则首选 PN。EN 适合使用假牙或经济有限的患者,尽管其可能会带来心理不适。未来需要更大样本量和更长随访时间的研究来验证我们的发现。该试验的注册号为 ChiCTR2100049547,注册日期为 2021 年 8 月 2 日。

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