电话回访式饮食干预在预防食管癌术后吻合口狭窄中的作用分析

目的探讨电话回访式饮食干预在预防食管癌术后吻合口狭窄中的作用。方法选取2012年4月~2013年1月行食管癌手术的127例患者,按出院日期分为两组,单日出院者为对照组(n=54),双日出院者为试验组(n=73),对照组出院后提供常规饮食指导方案;试验组在常规饮食指导的基础上,于出院后2~20 d,隔日由专人以电话方式进行饮食干预,询问并记录饮食情况。比较两组患者术后1、3个月的营养状况及吻合口狭窄情况。结果两组患者术后复查时,体重、营养状况较术前有明显改善,组间或不同时期组内比较差异有统计学意义(P<0.05);术后1个月进普通食物时,对照组51.9%的患者、试验组53.4%的患者存在哽噎感,但组间比较差异无统计学意义(P>0.05)。对照组中只有20.4%的患者遵守饮食教育,低于试验组78.1%的遵医率;对照组吻合口狭窄率为33.3%,吻合口直径平均(7.3±1.4)mm,而试验组吻合口狭窄率仅为12.3%,吻合口直径平均(11.2±1.3)mm;3项指标组间比较差异均有统计学意义(P<0.05)。结论电话回访式饮食干预对食管癌患者术后的营养状况及预防术后吻合口狭窄起到积极作用。

The role analysis of telephone follow-up diet intervention on prevention of postoperative anastomotic stenosis of esophageal carcinoma

Objective To explore the role of telephone follow-up diet intervention on prevention of postoperative anastomotic stenosis of esophageal carcinoma.Methods 127 cases of esophageal carcinoma patients who operated from April 2012 to January 2013 were selected and divided into two groups according to the date of discharge.Odd date discharge was as the control group （n =54）,even date discharge was as experimental group （n =73）.The control group was provided with routine diet guidance; while in experimental group,the patients were first received routine diet guidance after discharge,and after 2-20 days,the diet was inquired and recorded by telephone dietary intervention given by specific person every other day.The nutritional status of 1 month,3 months after operation and the postoperative anastomotic stenosis were compared between the two groups.Results The body weight,nutritional status were improved significantly compared with preoperation in postoperative review,there were statistically significant differences both between the groups and in different periods within groups （P ＜ 0.05）; in the ordinary diet for 1 months after operation,53.4％ of patients in experimental group and 51.9％ patients in control group were existed feeling of choking,but no statistical significance was tested between the two groups （P ＞ 0.05）.While in the control group,only 20.4％ patients who complied with the diet education,less than the 78.1％ compliance rate of experimental group; the anastomotic stenosis rate of control group was 33.3％,with the average diameter of （7.3±1.4） mm; while in experimental group,the rate was only 12.3％,with the average diameter of （11.2±1.3） mm; there were statistical significance in the 3 indexes between two groups （P ＜ 0.05）.Conclusion Telephone follow-up type of diet interv ention plays a positive role in postoperative nutritional status and prevention of postoperative anastomotic stenosis of patients with esophageal carcinoma.