系统性饮食指导在直肠癌患者围术期中的应用

刘小凤 黄朝意 江志琴 周桦 黄春英

【摘要】 目的：探討系统性饮食指导在直肠癌患者围术期中的应用。方法：选择2020年1月-2021年6月本院120例直肠癌Miles术患者作为研究对象，随机分为对照组和试验组，每组60例。两组患者均进行常规围术期护理，对照组肠道准备给予常规饮食指导，试验组给予系统性饮食指导。观察比较两组患者肛门排气时间、术后肠鸣音恢复时间、住院费用、住院时间，入院时、出院时白蛋白水平、体重指数、焦虑（SAS）、抑郁（SDS）评分以及护理满意度。结果：试验组肛门排气时间、术后肠鸣音恢复时间、住院时间均较对照组短（P<0.05），住院费用较对照组少（P<0.05）。出院时，两组体重指数均较入院时降低，白蛋白均较入院时升高，而且试验组体重指数、白蛋白水平均较对照组高（P<0.05）。出院时，两组SDS、SAS评分均较入院时降低，而且试验组均较对照组低（P<0.05）。试验组护理满意度为96.67%，高于对照组的86.67%，差异有统计学意义（P<0.05）。结论：系统性饮食指导在直肠癌患者围术期应用，能够促进术后康复，缓解不良情绪，改善营养状况，提高护理满意度，值得推广。

【关键词】 系统性饮食指导 直肠癌 围术期 护理 营养

Application of Systematic Dietary Guidance in Perioperative Period of Rectal Cancer Patients/LIU Xiaofeng， HUANG Chaoyi， JIANG Zhiqin， ZHOU Hua， HUANG Chunying. //Medical Innovation of China， 2021， 18（35）： -110

[Abstract] Objective： To explore the application of systematic dietary guidance in perioperative period of patients with rectal cancer. Method： A total of 120 patients undergoing Miles operation for rectal cancer in our hospital from January 2020 to June 2021 were randomly divided into control group and experimental group， with 60 cases in each group. The patients in both groups received perioperative nursing， the control group was given routine dietary guidance for intestinal preparation， and the experimental group was given systematic dietary guidance. The anal exhaust time， postoperative bowel sound recovery time， hospitalization expenses， hospitalization time， albumin level at admission and discharge， body mass index at admission and discharge， anxiety （SAS） scores at admission and discharge， depression （SDS） scores at admission and discharge， and nursing satisfaction were observed and compared between the two groups. Result： The anal exhaust time， postoperative bowel sound recovery time， hospitalization time in the experimental group were shorter than those in the control group （P<0.05）， and hospitalization expenses was less than that in the control group （P<0.05）. At discharge， the body mass index of the two groups were lower than those at admission， the albumin levels were higher than those at admission， the body mass index and albumin level of the experimental group were higher than those of the control group （P<0.05）. At discharge， the SDS and SAS scores of the two groups were lower than those at admission， and those of the experimental group were lower than those of the control group （P<0.05）. The nursing satisfaction of the experimental group was 96.67%， which was higher than 86.67% of the control group， the difference was statistically significant （P<0.05）. Conclusion： The application of systematic dietary guidance in the perioperative period of rectal cancer patients can promote postoperative rehabilitation， alleviate bad emotions， improve nutritional status and improve nursing satisfaction， which is worthy of promotion.

[Key words] Systematic dietary guidance Rectal cancer Perioperative period Nursing Nutrition

First-author’s address： Jiangxi Cancer Hospital （Jiangxi Second People’s Hospital）， Nanchang 330000， China

doi：10.3969/j.issn.1674-4985.2021.35.026

直肠癌是常见的恶性肿瘤之一，其发病率和死亡率呈上升趋势，中国直肠癌患者主要类型为低位直肠癌，而直肠癌治疗方式主要为腹会阴联合直肠癌根治术（Miles手术）[1]。欧洲临床营养与代谢学会的近期指导方针主张对癌症患者进行营养支持，并同时给予更多关注;癌症恶病质的挑战在于营养支持不能完全逆转。……