路径式营养管理在食管癌患者围术期的应用研究

目的 探讨路径式营养管理在食管癌围术期患者中的应用效果。方法 选取2018年1月至2018年7月在四川省肿瘤医院胸外科接受食管癌根治手术治疗的患者156例，随机分为干预组（n=78）和对照组（n=78），干预组采用路径式营养管理，对照组采用常规营养管理，比较两组患者在术后7d血红蛋白、前白蛋白、体质指数（BMI）、预后营养指数（PNI）等营养指标、术后并发症发生率及术后住院时间。结果 干预组患者术后7d血红蛋白（126.09±16.69）g/L、前白蛋白（208.74±38.51）mg/L、BMI（22.28±2.05）kg/m2、PNI（46.62±4.03）优于对照组，差异有统计学意义（P<0.05）；干预组患者胸腔积液发生率低于对照组，差异有统计学意义（t=4.02，P=0.04）；干预组患者住院时间短于对照组，差异有统计学意义（t=6.53，P=0.03）。结论 路径式营养管理能有效改善食管癌围术期患者营养状况、降低并发症发生率、缩短术后住院时间。

Application of pathway nutrition management in perioperative period of patients with esophageal cancer

Objective To explore the application effect of pathological nutrition management in perioperative patients with esophageal cancer.Methods A total of 156 patients who underwent radical surgery for esophageal cancer in the Department of Thoracic Surgery,Sichuan Cancer Hospital from January 2018 to July 2018 were randomly divided into intervention group(n=78)and control group(n=78).Pathological nutrition management was used in the intervention group,and the control group was treated with routine nutrition management.The nutritional indexes such as hemoglobin,prealbumin,body mass index(BMI),prognostic nutritional index(PNI)and postoperative complications were compared between the two groups,as well as the length of postoperative hospital stay.Results The hemoglobin(126.09±16.69)g/L,prealbumin(208.74±38.51)mg/L,BMI(22.28±2.05)kg/m2 and PNI(46.62±4.03)of the observation group were better than those in the control group at 7 days after operation(P<0.05).The incidence of pleural effusion in the intervention group was lower than that in the control group,and the difference was statistically significant(t=4.02,P=0.04).The hospital stay of the intervention group was shorter than that of the control group,and the difference was statistically significant.(t=6.53,P=0.03).Conclusions Pathway nutrition management can effectively improve the nutritional status of perioperative patients with esophageal cancer,reduce the occurrence of complications,and shorten the postoperative hospital stay.It is worthy of clinical promotion.