Zhu Ling, Cheng Jun, Xiao Fei, Mao Yan-Yan
Department of Gastrointestinal Surgery, Wuhan Fourth Hospital, Wuhan 430000, Hubei Province, China.
Department of Gastrointestinal Surgery, Qianjiang Central Hospital, Qianjing 433100, Hubei Province, China.
World J Gastrointest Surg. 2024 Dec 27;16(12):3737-3744. doi: 10.4240/wjgs.v16.i12.3737.
Postoperative patients undergoing gastrointestinal surgery often encounter challenges such as low immune function, delayed wound healing owing to surgical trauma, and increased nutritional demands during recovery.
To assess the effect of comprehensive nutritional support program on immune function and wound healing in patients undergoing gastrointestinal surgery.
This retrospective comparative study included 60 patients who underwent gastrointestinal surgery, randomly assigned to either the experimental group ( = 30) or the control group ( = 30). The experimental group received comprehensive nutritional support, including a combination of enteral and parenteral nutrition, whereas the control group received only conventional comprehensive nutritional support. Evaluation indicators included immune function markers (, white blood cell count, lymphocyte subsets), wound healing (wound infection rate, healing time), pain score [visual analog scale (VAS) score], and psychological status (anxiety score, depression score) 7 days post-surgery) and duration of stay.
The immune function of patients in the experimental group was significantly better than that in the control group. The white blood cell count was 8.52 ± 1.19 × 10/L in the experimental group 6.74 ± 1.31 × 10/L ( < 0.05). The proportion of CD4+ T cells was higher in the experimental group (40.09% ± 4.91%) than that in the control group (33.01% ± 5.08%) ( < 0.05); the proportion of CD8+ T cells was lower (21.79% ± 3.38% 26.29% ± 3.09%; < 0.05). The CD4+/CD8+ ratio was 1.91 ± 0.32 in the experimental group whereas 1.13 ± 0.23 in the control group ( < 0.05). The wound infection rate of the experimental group was significantly lower than that of the control group (10% 30%, < 0.05), and the wound healing time was shorter (10.35 ± 2.42 days 14.42 ± 3.15 days, < 0.05). The VAS score of the experimental group was 3.05 ± 1.04, and that of the control group was 5.11 ± 1.09 ( < 0.05); the anxiety score (Hamilton Anxiety Rating Scale) was 8.88 ± 1.87, and that of the control group was 12.1 ± 3.27 ( < 0.05); the depression score (Hamilton Depression Rating Scale) was 7.37 ± 1.41, and that of the control group was 11.79 ± 2.77 ( < 0.05). In addition, the hospitalization time of the experimental group was significantly shorter than that of the control group (16.16 ± 3.12 days 20.93 ± 4.84 days, < 0.05).
A comprehensive nutritional support program significantly enhances immune function, promote wound healing, reduces pain, improves psychological status, and shortens hospitalization stays in patients recovering from gastrointestinal surgery.
接受胃肠道手术的术后患者常面临诸多挑战，如免疫功能低下、手术创伤导致伤口愈合延迟以及恢复期间营养需求增加。
评估综合营养支持方案对胃肠道手术患者免疫功能和伤口愈合的影响。
这项回顾性对照研究纳入了60例接受胃肠道手术的患者，随机分为实验组（n = 30）和对照组（n = 30）。实验组接受包括肠内营养和肠外营养联合的综合营养支持，而对照组仅接受常规综合营养支持。评估指标包括免疫功能标志物（白细胞计数、淋巴细胞亚群）、伤口愈合情况（伤口感染率、愈合时间）、疼痛评分[视觉模拟量表（VAS）评分]以及心理状态（焦虑评分、抑郁评分）（术后7天）和住院时间。
实验组患者的免疫功能明显优于对照组。实验组白细胞计数为8.52±1.19×10⁹/L，对照组为6.74±1.31×10⁹/L（P < 0.05）。实验组CD4⁺T细胞比例高于对照组（40.09%±4.91%对33.01%±5.08%，P < 0.05）；CD8⁺T细胞比例较低（21.79%±3.38%对26.29%±3.09%；P < 0.05）。实验组CD4⁺/CD8⁺比值为1.91±0.32，对照组为1.13±0.23（P < 0.05）。实验组伤口感染率显著低于对照组（10%对30%，P < 0.05），且伤口愈合时间更短（10.35±2.42天对14.42±3.15天，P < 0.05）。实验组VAS评分为3.05±1.04，对照组为5.11±1.09（P < 0.05）；焦虑评分（汉密尔顿焦虑量表）为8.88±1.87，对照组为12.1±3.27（P < 0.05）；抑郁评分（汉密尔顿抑郁量表）为7.37±1.41，对照组为11.79±2.77（P < 0.05）。此外，实验组住院时间明显短于对照组（16.16±3.12天对20.93±4.84天，P < 0.05）。
综合营养支持方案可显著增强胃肠道手术恢复患者的免疫功能，促进伤口愈合，减轻疼痛，改善心理状态，并缩短住院时间。
