|
|
|
| Effect of optimized nutritional pathway on gastrointestinal function and immune indexes after colorectal cancer surgery |
| XIONG Lancai LUO Jiong XU Xiaowei |
| The First Department of Oncology, the First People’s Hospital of Lianyungang, Jiangsu Province, Lianyungang 222000, China |
|
|
|
Abstract Objective To investigate the effect of optimized nutritional pathway on gastrointestinal function and immune indexes after colorectal cancer (CRC) surgery. Methods A total of 136 patients with CRC who underwent radical resection in the First People’s Hospital of Lianyungang, Jiangsu Province from April 2018 to May 2021 were selected. According to the random number table method, the patients were divided into routine group (n = 68, with routine nutritional care) and optimization group (n = 68, with optimized nutritional path), the recovery time of gastrointestinal function, immune indexes, postoperative nutritional risk score, and incidence of complications were compared between the two groups. Results The time of bowel sounds, time of first anal exhaust, time of first defecation, time of first eating, time of resuming normal eating, and incidence of complications in the optimization group were lower than those in the conventional group (P ＜ 0.05). The levels of CD4+, CD8+, and CD4+/CD8+ in the two groups at seven days postoperative were lower than those at one day before operation, and the levels of CD4+ and CD4+/CD8+ in the optimization group were higher than those in the conventional group, and the level of CD8+ was lower than that in the conventional group (P ＜ 0.05). The nutritional risk scores of the two groups at seven days after operation were lower than those at enrollent, and the optimization group was lower than the conventional group (P ＜ 0.05). Conclusion The optimized nutritional pathway in CRC is helpful to improve gastrointestinal function, immune indicators and nutritional level, and reduce the risk of postoperative complications.
|
|
|
|
|
|
[1] 董明，周建平，姚宏伟.结直肠癌围手术期营养治疗中国专家共识（2019版）[J].中国实用外科杂志，2019，39（6）：533-537.
[2] 中华医学会肿瘤学分会.中国结直肠癌诊疗规范（2020年版）[J].中华外科杂志，2020，58（8）：561-585.
[3] 中华医学会外科学分会结直肠外科学组，中华医学会外科学分会营养支持学组，中国医师协会外科医师分会结直肠外科医师委员会.结直肠癌围手术期营养治疗中国专家共识（2019版）[J].中国实用外科杂志，2019，39（6）：533-537.
[4] Acehan S，Gulen M，Is?覦kber C，et al. mNUTRIC tool is capable to predict nutritional needs and mortality early in patients suffering from severe pneumonia [J]. Clin Nutr ESPEN，2021，3（45）：184-191.
[5] 李敏，漆凤霞，鞠楷，等.242例老年结直肠癌术前MNA-SF与NRS2002营养筛查结果及预后分析[J].河北医学，2017，23（10）：1623-1628.
[6] Bauer J，Capra S，Ferguson M. Use of the scored PatientGenerated Subjective Global Assessment （PG-SGA） as a nutrition assessment tool in patients with cancer [J]. Eur J Clin Nutr，2002，56（8）：779-785.
[7] Barnell EK，Kang Y，Barnell AR，et al. Multitarget Stool RNA Test for Noninvasive Detection of Colorectal Neoplasias in a Multicenter，Prospective，and Retrospective Cohort [J]. Clin Transl Gastroenterol，2021，12（5）：00360.
[8] Kim SY，Kim HS，Kim YT，et al. Colonoscopy Versus Fecal Immunochemical Test for Reducing Colorectal Cancer Risk：A Population-Based Case-Control Study [J]. Clin Transl Gastroenterol，2021，12（5）：00350.
[9] Dubowitz J，Hiller J，Riedel B. Anesthetic technique and cancer surgery outcomes [J]. Curr Opin Anaesthesiol，2021， 34（3）：317-325.
[10] Alhayyan AM，McSorley ST，Kearns RJ，et al. The effect of anesthesia on the magnitude of the postoperative systemic inflammatory response in patients undergoing elective surgery for colorectal cancer in the context of an enhanced recovery pathway：A prospective cohort study [J]. Medicine，2021，100（2）：23997.
[11] Wang Z，Peng Y，Cai X，et al. Impact of total parenteral nutrition standardization led by pharmacist on quality in postoperative patients with colorectal cancer [J]. Eur J Clin Nutr，2019，73（2）：243-249.
[12] Ma CJ，Huang CW，Yeh YS，et al. Supplemental home parenteral nutrition improved nutrition status with comparable quality of life in malnourished unresectable/metastatic gastric cancer receiving salvage chemotherapy [J]. Support Care Cancer，2021，29（4）：1977-1988.
[13] 张敏，吕建鸿，唐玲玲，等.术前口服复方碳水化合物饮品对妇科腹腔镜手术后胃肠功能影响[J].中华麻醉学杂志，2019，39（7）：805-808.
[14] 杨桦，陈国庆.免疫营养素在营养支持治疗中作用[J].中华消化外科杂志，2019，18（10）：912-915.
[15] 梁锐，陈改云，王素凡，等.免疫肠内营养治疗急性应激随机对照研究[J].中华急诊医学杂志，2019，28（5）：604-608.
[16] 梁海，吴炜，贾淑云，等.结直肠癌住院营养状态与药师营养干预情况调查[J].实用药物与临床，2020，23（7）：632-636.
[17] Najumudeen AK，Ceteci F，Fey SK，et al. The amino acid transporter SLC7A5 is required for efficient growth of KRAS-mutant colorectal cancer [J]. Nat Genet，2021，53（1）：16-26.
[18] Wu J，He H，Zhang Q，et al. Fasting blood glucose was linearly associated with colorectal cancer risk in the population without self-reported diabetes mellitus history [J]. Medicine，2021，100（34）：26974.
[19] Han J，Jiang Q，Ma R，et al. Norepinephrine-CREB1-miR-373 axis promotes progression of colon cancer [J]. Mol Oncol，2020，14（5）：1059-1073.
[20] 庄成乐.围手术期骨骼肌质量与功能对术后临床结局影响及机制研究[D].温州：温州医科大学，2016.
[21] 于娣，龙玲，赵鹤龄.血流动力学不稳定重症肠内营养耐受性与安全性[J].中华急诊医学杂志，2016，25（1）：113-116.
[22] 储亚琴，江志伟，邵明月，等.结直肠癌术后摄入口服营养补充剂依从性现状及影响因素分析[J].中国护理管理，2020，20（12）：1790-1794.
[23] 贺艳玲，蔡华，张军玲，等.晚期结直肠癌营养指标与化疗预后相关性分析[J].肿瘤代谢与营养电子杂志，2020， 7（3）：295-300.
[24] 卢燕霞，章晓霞，戴芳华.基于营养风险筛查与耐受评估护理干预对结直肠癌术后营养及胃肠功能恢复影响[J].护理实践与研究，2020，17（5）：60-62.
[25] 陈天文，温贺新，刘牧林.术前预后营养指数对结直肠癌根治术后生存预测价值研究[J].中华普通外科学文献（电子版），2020，14（4）：261-265. |
|
|
|
