术前肠内营养支持治疗在口腔鳞癌患者加速康复中的应用

doi:10.19438/j.cjoms.2020.02.006

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (2): 122-126.doi: 10.19438/j.cjoms.2020.02.006

术前肠内营养支持治疗在口腔鳞癌患者加速康复中的应用

王延，蒋通辉，庄海，张继生，卜寿山

南京医科大学第一附属医院口腔科，江苏南京 210029

收稿日期:2019-07-29 修回日期:2019-11-04 出版日期:2020-03-20 发布日期:2020-04-30
通讯作者: 卜寿山，E-mail:bushsh@vip.sina.com
作者简介:王延（1993-）男，在读硕士研究生，E-mail:wang666yan666@126.com
基金资助:
国家自然科学基金（81670967）

Application of preoperative enteral nutrition support in patients with oral squamous cell carcinomas in the enhanced recovery after surgery

WANG Yan, JIANG Tong-hui, ZHUANG Hai, ZHANG Ji-sheng, BU Shou-shan.

Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University. Nanjing 210029, Jiangsu Province, China

Received:2019-07-29 Revised:2019-11-04 Online:2020-03-20 Published:2020-04-30

摘要/Abstract

摘要： 目的:：评估口腔癌患者术前肠内营养支持的效果。方法:：将56例确诊口腔鳞癌的患者分为试验组（37例）和对照组（19例），试验组在常规饮食的基础上术前连续口服营养制剂7 d以上，对照组术前常规饮食。记录患者围术期体重指数、血清白蛋白、血清前白蛋白、血清离子浓度变化以及术后营养相关不良反应、术后并发症、术后首次排气时间、术后住院天数、总住院费用。采用 SPSS 17.0软件包进行数据录入与分析。结果:：试验组患者术后第7天血清白蛋白、术后第3天和第7天血清前白蛋白量、出院时体重指数显著高于对照组；试验组患者术后恶心、呕吐、腹泻、便秘发生率显著低于对照组；试验组患者相比于对照组患者术后首次排气时间、术后住院天数显著缩短，总住院费用显著降低（P<0.05）。结论:：给予口腔鳞癌手术患者术前肠内营养支持是一种安全有效的治疗方式，可改善患者术后营养状况，有效降低术后营养相关不良反应发生率，缩短术后住院时间，降低住院费用。

关键词: 肠内营养, 口腔癌, 预适应, 术后加速康复

Abstract: PURPOSE： To evaluate the effect of preoperative enteral nutrition support for patients with oral squamous cell carcinomas. METHODS: Fifty-six patients with oral squamous cell carcinoma were divided into experimental group (n=37) and control group (n=19). On the basis of routine diet, patients in the experimental group received oral nutritional preparations for more than 7 days before operation, while patients in the control group received routine diet before operation. The changes of body mass index, serum albumin, serum prealbumin, serum ion concentration, nutrition-related adverse reactions, complications, first exhaust time, hospital stay and total hospitalization expenses were recorded. SPSS 17.0 software package was used for data input and analysis. RESULTS: The serum albumin, at 7 days prealbumin and body mass index, at 3 days and 7 days after operation in the experimental group were significantly higher than those in the control group; the incidence of nausea, vomiting, diarrhea and constipation in the experimental group was significantly lower than that in the control group; the experimental group was significantly lower than that in the control group at the first time of exhaust after operation; the duration of hospitalization and the total cost of hospitalization in the experimental group were significantly shortened (P<0.05). CONCLUSIONS: Preoperative enteral nutrition support is a safe and effective treatment for oral squamous cell carcinoma patients. It can improve the nutritional status of patients after operation, effectively reduce the incidence of nutrition-related adverse reactions after operation, shorten the length of hospital stay after operation and reduce the cost of hospitalization.

Key words: Enteral nutrition, Oral cancer, Pre-adaptation, Enhanced recovery after surgery

中图分类号:

R739.8

王延，蒋通辉，庄海，张继生，卜寿山. 术前肠内营养支持治疗在口腔鳞癌患者加速康复中的应用[J]. 中国口腔颌面外科杂志, 2020, 18(2): 122-126.

WANG Yan, JIANG Tong-hui, ZHUANG Hai, ZHANG Ji-sheng, BU Shou-shan.. Application of preoperative enteral nutrition support in patients with oral squamous cell carcinomas in the enhanced recovery after surgery[J]. China J Oral Maxillofac Surg, 2020, 18(2): 122-126.

参考文献

[1] Torre LA, Bray F, Siegel RL, et al. Global cancer statistics,2012[J]. CA Cancer J Clin, 2015, 65(2): 87-108.
[2] Chi AC, Day TA, Neville BW. Oral cavity and oropharyngeal squamous cell carcinoma-an update[J]. CA Cancer J Clin, 2015, 65(5): 401-421.
[3] Omura K. Current status of oral cancer treatment strategies: surgical treatments for oral squamous cell carcinoma [J]. Int J Clin Oncol, 2014, 19(3): 423-430.
[4] Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery [J]. Clin Nutr, 2017, 36(3): 623-650.
[5] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78(5): 606-617.
[6] Morgan KA, Lancaster WP, Walters ML, et al. Enhanced recovery after surgery protocols are valuable in pancreas surgery patients [J]. J Am Coll Surg, 2016, 222(4): 658-664.
[7] Khalil A, Ganesh S, Hughes C, et al. Evaluation of the enhanced recovery after surgery protocol in living liver donors[J]. Clin Transplant, 2018, 32(8): e13342.
[8] Gonfiotti A, Viggiano D, Bongiolatti S, et al. Enhanced recovery after surgery (ERAS ) in thoracic surgical oncology [J]. Future Oncol, 2018,14(6s): 33-40.
[9] Ali ZS, Ma TS, Ozturk AK, et al. Pre-optimization of spinal surgery patients: Development of a neurosurgical enhanced recovery after surgery (ERAS) protocol[J]. Clin Neurol Neurosurg, 2018,164: 142-153.
[10] Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics [J]. Clin Nutr, 2006, 25(2): 180-186.
[11] Kruizenga H, van Keeken S, Weijs P, et al. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer [J]. Am J Clin Nutr, 2016, 103(4): 1026-1032.
[12] Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition [J]. Clin Nutr, 2017, 36(5): 1187-1196.
[13] Boullata JI, Carrera AL, Harvey L, et al. ASPEN safe practices for enteral nutrition therapy[J]. JPEN J Parenter Enteral Nutr, 2017,41(1): 15-103.
[14] Horowitz M, Neeman E, Sharon E, et al. Exploiting the critical perioperative period to improve long-term cancer outcomes [J]. Nat Rev Clin Oncol, 2015, 12(4): 213-226.
[15] Gustafsson UO, Oppelstrup H, Thorell A, et al. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study[J]. World J Surg, 2016, 40(7): 1741-1747.
[16] Gillis C, Carli F. Promoting perioperative metabolic and nutritional care [J]. Anesthesiology, 2015, 123(6): 1455-1472.
[17] Alazawi W, Pirmadjid N, Lahiri R, et al. Inflammatory and immune responses to surgery and their clinical impact [J]. Ann Surg, 2016, 264(1): 73-80.
[18] Jie B, Jiang ZM, Nolan MT, et al. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk[J]. Nutrition, 2012, 28(10): 1022-1027.
[19] Kubota K, Kuroda J, Yoshida M, et al. Preoperative oral supplementation support in patients with esophageal cancer [J]. J Nutr Health Aging, 2014, 18(4): 437-440.

术前肠内营养支持治疗在口腔鳞癌患者加速康复中的应用

Application of preoperative enteral nutrition support in patients with oral squamous cell carcinomas in the enhanced recovery after surgery

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