Wang Le, Tian Hongliang, Li Long, Ye Chen, Cui Jiaqu, Lin Zhiliang, Yang Bo, Zhao Di, Li Ning, Feng Xiaobo, Chen Qiyi
Department of Functional Intestinal Diseases, General Surgery of Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Shanghai Gastrointestinal Microecology Research Center, Shanghai, China.
Front Med (Lausanne). 2024 Sep 3;11:1335203. doi: 10.3389/fmed.2024.1335203. eCollection 2024.
Many patients with constipation also suffer from varying degrees of malnutrition, and the relationship between the two conditions is a vicious cycle. Surgery is the final step in the treatment of constipation, with a success rate of up to 95%. This study aims to investigate the effects of surgical treatment on the nutritional status of patients with chronic constipation and malnutrition.
A total of 60 patients with chronic constipation and various degrees of malnutrition who underwent surgery in our department from January 2020 to March 2023 were included in this study. Biochemical tests including BMI, albumin, total protein, hemoglobin, cholesterol and lymphocyte count were conducted, as well as measurements of inflammatory markers such as Interleukin-6 (IL-6), Interleukin-8 (IL-8), and C-reactive protein (CRP). Additionally, multiple nutritional risk screening scales (NRS2002, MUST, NRI, and MNA) and the prognostic nutritional index (PNI) were used to assess the nutritional status of patients before surgery, as well as at 1 month, 3 months, and 6 months post-surgery. Finally, we analyzed the factors influencing postoperative recovery outcomes in patients.
Compared to pre-operation, the BMI of patients significantly increased at 1 month, 3 months, and 6 months after the operation, with statistically significant differences ( < 0.001). Multiple nutritional risk assessment tools (NRS2002, MUST, NRI, and MNA), as well as the prognostic nutritional index (NPI), indicated a reduction in nutritional risk and improvement in nutritional status at 1, 3, and 6 months post-surgery, compared to pre-surgery levels ( < 0.001). The levels of albumin, total protein, and hemoglobin in patients at 1, 3, and 6 months after the surgery were significantly higher than those before the surgery ( < 0.001). However, there was no significant change in the number of lymphocytes. Inflammatory markers such as IL-6, IL-8, and CRP exhibited a significant decrease after the surgery, reaching normal levels at 6 months post-surgery ( < 0.001). Low BMI, low PNI, and low cholesterol levels are independent risk factors for patient prognosis ( < 0.05).
Surgical treatment can enhance the nutritional status of constipation patients with malnutrition, which in turn promotes the restoration of intestinal motility. The patient's nutritional status will impact the postoperative recovery outcomes.
许多便秘患者还伴有不同程度的营养不良，二者相互影响形成恶性循环。手术是便秘治疗的最后手段，成功率可达95%。本研究旨在探讨手术治疗对慢性便秘伴营养不良患者营养状况的影响。
选取2020年1月至2023年3月在我科接受手术的60例慢性便秘伴不同程度营养不良患者。进行了包括体重指数（BMI）、白蛋白、总蛋白、血红蛋白、胆固醇和淋巴细胞计数的生化检测，以及白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和C反应蛋白（CRP）等炎症标志物的检测。此外，使用多种营养风险筛查量表（NRS2002、MUST、NRI和MNA）和预后营养指数（PNI）评估患者术前、术后1个月、3个月和6个月的营养状况。最后，分析影响患者术后恢复结局的因素。
与术前相比，患者术后1个月、3个月和6个月的BMI显著升高，差异有统计学意义（<0.001）。多种营养风险评估工具（NRS2002、MUST、NRI和MNA）以及预后营养指数（NPI）显示，与术前水平相比，术后1个月、3个月和6个月时营养风险降低，营养状况改善（<0.001）。患者术后1个月、3个月和6个月时的白蛋白、总蛋白和血红蛋白水平显著高于术前（<0.001）。然而，淋巴细胞数量无显著变化。IL-6、IL-8和CRP等炎症标志物术后显著下降，术后6个月恢复正常水平（<0.001）。低BMI、低PNI和低胆固醇水平是影响患者预后的独立危险因素（<0.05）。
手术治疗可改善便秘伴营养不良患者的营养状况，进而促进肠道动力恢复。患者的营养状况会影响术后恢复结局。
