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营养支持团队模式在全胃切除联合Roux-en-Y吻合术患者管理中的疗效

Efficacy of the nutritional support team model in the management of patients undergoing total gastrectomy combined with Roux-en-Y anastomosis.

作者信息

Su Wenmian, Yang Yang, Wang Qian, Zhang Wanqiong

机构信息

Wenmian Su Department of Pharmacy Intravenous Admixture Services, Xingtai Central Hospital, Xingtai, Hebei Province 054000, P.R. China.

Yang Yang Department of Gastrointestinal surgery, Xingtai Central Hospital, Xingtai, Hebei Province 054000, P.R. China.

出版信息

Pak J Med Sci. 2025 Jan;41(1):141-146. doi: 10.12669/pjms.41.1.11112.

Abstract

OBJECTIVE

To explore the efficacy of the nutritional support team (NST) management model in patients undergoing total gastrectomy combined with Roux-en-Y anastomosis.

METHODS

Clinical data of 102 patients who underwent total gastrectomy combined with Roux-en-Y anastomosis in Xingtai Central Hospital from January 2020 to October 2023 were retrospectively collected. Of 102 patients, 53 received the NST model of management (NST group), while 49 were managed by the conventional nutritional support (TN group). The nutritional and immune function status of the two groups before and seven days after the surgery, postoperative rehabilitation status, and the incidence of complications were compared.

RESULTS

After the surgery, levels of albumin and total protein in both groups increased compared to before the surgery and were significantly higher in the NST group compared to the TN group (<0.05). Levels of CD3, CD4, CD4/CD8 in the two groups increased compared to preoperative levels and were significantly higher than the TN group compared to the NST group. In contrast, postoperative CD8 levels decreased and were significantly lower in the NST group (<0.05). The duration of anal exhaust, defecation, and hospitalization in the NST group of patients was shorter (<0.05), but no significance was found in the incidence of complications between the two groups (3.78% 16.33%) (>0.05).

CONCLUSIONS

For patients undergoing total gastrectomy combined with Roux-en-Y anastomosis, the NST nutritional management model can effectively improve nutritional status, enhance immune function, shorten the postoperative recovery process, and the incidence of complications is equivalent to that of patients receiving conventional nutritional support.

摘要

目的

探讨营养支持团队(NST)管理模式在全胃切除术联合Roux-en-Y吻合术患者中的疗效。

方法

回顾性收集2020年1月至2023年10月在邢台市中心医院行全胃切除术联合Roux-en-Y吻合术的102例患者的临床资料。102例患者中,53例接受NST管理模式(NST组),49例接受传统营养支持管理(TN组)。比较两组手术前及手术后7天的营养和免疫功能状态、术后康复状况及并发症发生率。

结果

术后,两组白蛋白和总蛋白水平均较术前升高,且NST组显著高于TN组(<0.05)。两组CD3、CD4、CD4/CD8水平较术前升高,且NST组显著高于TN组。相比之下,术后CD8水平降低,且NST组显著更低(<0.05)。NST组患者肛门排气、排便及住院时间更短(<0.05),但两组并发症发生率无显著差异(3.78% 16.33%)(>0.05)。

结论

对于行全胃切除术联合Roux-en-Y吻合术的患者,NST营养管理模式可有效改善营养状况,增强免疫功能,缩短术后恢复进程,且并发症发生率与接受传统营养支持的患者相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9998/11755319/fe6f66cd4fcb/PJMS-41-141-g001.jpg

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