Department of Clinic Nutrition, Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital Clinical College of Xuzhou Medical University, Jiangsu, China.
Department of School of Public Health, Xuzhou Medical University, Jiangsu, China.
Asia Pac J Clin Nutr. 2024 Dec;33(4):581-588. doi: 10.6133/apjcn.202412_33(4).0013.
The current study aimed to explore the effect of nutritional prehabilitation on the clinical prognosis of elderly patients undergoing abdominal cancer surgery.
A retrospective study was conducted, where participants were divided into two groups based on whether they received oral nutritional supplementation at the first outpatient visit. The nutritional prehabilitation group (n=41) adopted a nutritional prehabilitation mode (a standard energy intake of 25-30 kcal/kg· d was recommended). While the control group (n=55) received routine care. All patients underwent laparoscopic surgery according to the National Comprehensive Cancer Network (NCCN) guidelines. Changes in nutritional status, complications, psychological status, symptoms, hospitalization days, and expenditures were compared between the two groups.
Both groups of patients experienced weight loss. However, the decline in body weight in the prehabilitation group was less than that in the control group (-1.88 vs. -2.56 kg, p < 0.001). In the comparison of nutritional prehabilitation group and control group, significant improvements were observed in the Hospital Anxiety Scale scores (5 vs. 5, p = 0.01) and MD Anderson Symptom Inventory scores (3 vs. 0, p < 0.001) respectively. The infection rate in the nutritional prehabilitation group was lower than that in the control group (17.1% vs. 36.4%, p = 0.04). Additionally, patients in the nutritional prehabilitation group had significantly fewer hospitalization days at discharge (14.3 vs. 17.1 days, p = 0.03).
In elderly patients undergoing abdominal cancer surgery, a nutritional prehabilitation model may help maintain better physical and mental status, reduce infection rates, and shorten hospitalization days.
本研究旨在探讨营养预康复对接受腹部癌症手术的老年患者临床预后的影响。
本研究为回顾性研究，根据首次门诊是否接受口服营养补充，将参与者分为两组。营养预康复组（n=41）采用营养预康复模式（推荐标准能量摄入为 25-30kcal/kg·d）。对照组（n=55）接受常规护理。所有患者均按照美国国家综合癌症网络（NCCN）指南行腹腔镜手术。比较两组患者的营养状况变化、并发症、心理状态、症状、住院天数和费用。
两组患者均出现体重下降，但预康复组体重下降幅度小于对照组（-1.88 比-2.56kg，p<0.001）。营养预康复组与对照组相比，医院焦虑量表评分（5 比 5，p=0.01）和 MD 安德森症状量表评分（3 比 0，p<0.001）均显著改善。营养预康复组感染率低于对照组（17.1%比 36.4%，p=0.04）。此外，营养预康复组患者的出院时住院天数明显减少（14.3 比 17.1 天，p=0.03）。
在接受腹部癌症手术的老年患者中，营养预康复模式可能有助于维持更好的身心状态，降低感染率，并缩短住院时间。
