H2H营养管理模式下的持续营养补充对食管癌患者术后营养状况及生活质量的影响

Effect of continuous nutritional supplementation under H2H nutritional management model on postoperative nutritional status and quality of life of esophageal cancer patients

摘要:

本研究探讨H2H营养管理模式下的持续营养补充对食管癌患者术后营养状况及生活质量的影响。选取在我院胸外科首次确诊为食管癌并接受手术治疗的 81 例患者为研究对象,随机分为实验组和对照组。对照组实行常规营养管理,实验组在常规营养管理的基础上采取“H2H”营养管理模式,进行持续营养补充。结果显示,两组患者术后血红蛋白(Hb)浓度均有不同程度下降,且实验组术后3天的Hb浓度低于对照组(P=0.037)。术后3天的血清白蛋白(Alb)、前白蛋白(PA)浓度及术后1个月的Alb浓度实验组均高于对照组(P<0.05)。两组患者术后总蛋白(TP)和PA浓度均有下降,出院后逐渐回升,实验组的总体趋势高于对照组。出院后1个月和3个月的骨骼肌质量及骨骼肌指数实验组均高于对照组(P<0.05)。对生活质量进行评估,实验组术后6个月的躯体功能(P=0.043)、情绪功能(P=0.046)及总体健康水平得分(P=0.041)均明显高于对照组,差异有统计学意义。基于H2H营养管理模式下的持续营养补充可改善食管癌患者术后营养状况,提高生活质量。

Abstract:

This study investigated the impact of continuous nutritional supplementation under the H2H nutritional management model on postoperative nutritional status and quality of life of patients with esophageal cancer. 81 patients who were first diagnosed with esophageal cancer in the Thoracic Surgery Department of our hospital and received surgical treatment were selected as the research objects and randomly divided into the experimental group and the control group. The control group implemented routine nutritional management, while the experimental group adopted the "H2H" nutritional management model on the basis of routine nutritional management to provide continuous nutritional supplements. Results showed that the postoperative hemoglobin (Hb) concentration decreased to varying degrees in both groups, and the Hb concentration in the experimental group was lower than that in the control group at 3 days after surgery (P=0.037). The serum albumin (Alb), prealbumin (PA) concentrations 3 days after operation and the Alb concentration 1 month after operation in the experimental group were higher than those in the control group (P<0.05). The total protein (TP) and PA concentrations decreased after surgery in both groups, and gradually increased after discharge. The overall trend in the experimental group was higher than that in the control group. The skeletal muscle mass and skeletal muscle index in the experimental group at 1 and 3 months after discharge were higher than those in the control group (P<0.05). To evaluate the quality of life, the scores of physical function (P=0.043), emotional function (P=0.046) and overall health level (P=0.041) in the experimental group 6 months after surgery were significantly higher than those in the control group, with statistical significance. Continuous nutritional supplementation based on the H2H nutritional management model can improve the postoperative nutritional status of esophageal cancer patients and improve their quality of life.