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Received:July 20, 2022 Published Online:February 20, 2023
Received:July 20, 2022 Published Online:February 20, 2023
中文摘要: 目的 探讨术前预康复对胃癌患者术后胃肠功能、营养指标、生活质量及不良反应的影响。方法 纳入2019年11月至2022年3月于解放军联勤保障部队第九〇一医院接受胃癌根治术治疗的66例患者为研究对象，采用随机数字表法分为对照组（n=35）和研究组（n=31），对照组给予常规胃癌术前准备，研究组给予术前预康复，比较两组患者术后胃肠道功能恢复情况（术后首次排气、排便时间、首次恢复经口进食时间）、血清学营养指标（总蛋白、白蛋白、前白蛋白、血红蛋白）、术后肠内营养期间胃肠道不良反应、生存质量综合评定问卷(GQOL-74)评分。结果 与对照组相比，研究组患者术后首次恢复经口进食时间、恢复排便和排气时间均显著缩短（P<0.05）。术后1、3、7 d，研究组血清总蛋白、白蛋白、前白蛋白、血红蛋白水平均高于对照组（P<0.05）。术后肠内营养期间，研究组胃肠道不良反应总发生率少于对照组（6.45% vs25.71%, P<0.05）。术后7 d，两组患者GQOL-74评分较术后2 d均升高，且研究组高于对照组（P<0.05）。结论 胃癌根治术患者应用术前预康复，可明显改善术后胃肠功能、营养状况，降低不良反应发生率，促进生活质量的提高，有临床应用价值。
Abstract:ObjectiveTo investigate the effects of preoperative pre-rehabilitation on postoperative gastrointestinal function, nutritional indicators, quality of life and adverse reactions in patients with gastric cancer. MethodsA total of 66 patients who underwent radical gastrectomy for gastric cancer in the 901st Hospital of Joint Logistics Support Force of the CPLA from November 2019 to March 2022 were selected as the research subjects. The patients were divided into control group (n=35) and study group (n=31) by random number table method. The control group received routine preoperative preparation, and the study group received preoperative pre-rehabilitation. Postoperative gastrointestinal function recovery (first postoperative exhaust time, defecation time and the time to first oral feeding), serum nutritional indicators ［total protein (TP), albumin (Alb), prealbumin (PA) and hemoglobin (Hb)］, postoperative gastrointestinal adverse reactions during enteral nutrition, and the generic quality of life inventory-74 (GQOL-74) scores were compared between two groups. ResultsThe time to first oral feeding, defecation recovery time and exhaust time in the study group after operation were significantly shorter than those in the control group (P<0.05). The levels of serum TP, Alb, PA, and Hb were higher in the study group than those in the control group on day 1, day 3 and day 7 after operation (P<0.05). The total incidence of gastrointestinal adverse reactions in the study group during postoperative enteral nutrition was significantly lower than that in the control group (6.45% vs25.71%, P<0.05). The scores of GQOL-74 of the two groups on day 7 after operation were higher than those on day 2 after operation, and the study group had higher scores than the control group (P<0.05). ConclusionPreoperative pre-rehabilitation can significantly improve postoperative gastrointestinal function and nutritional status, reduce the incidence of gastrointestinal adverse reactions, and promote the improvement of quality of life in patients undergoing radical gastrectomy for gastric cancer.
keywords: Gastric cancer Radical gastrectomy Pre-rehabilitation Enteral nutrition Gastrointestinal function
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