口腔颌面恶性肿瘤合并糖尿病患者围术期营养状况调查分析

目的:调查分析口腔颌面恶性肿瘤合并糖尿病患者围术期营养状况.方法:收集接受手术治疗的口腔颌面恶性肿瘤合并糖尿病患者64例,并分别于术前、术后第1天、第3天、第7天清晨空腹抽取静脉血,检测血蛋白功能[血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)]、免疫功能[总淋巴细胞计数(L)、淋巴细胞百分比(L...

Investigation and analysis of perioperative nutritional status in patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus

PURPOSE: To analyze the nutritional status of patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus during perioperative period. METHODS: Sixty-four patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus were collected. Fasting venous blood of patients was extracted on the morning of the day before surgery and then at the 1st, 3rd and 7th day after surgery, respectively. The hemoglobin (Hb), total protein (TP), pre-albumin (PA), lymphocyte count (L), creatinine (Scr), uric acid (UA), urea nitrogen (BUN), glomerular filtration rate (EGFR_EPI_C), white blood cells (WBC) of the patients were detected. The intake of enteral nutrition on the 7th day after operation was investigated. The correlation between nutritional status and the length of stay was analyzed. SPSS 23.0 software package was used for statistical analysis. RESULTS: Compared with the indicators before surgery, the values of TP, ALB, PA, Hb were decreased significantly after surgery in all groups(P<0.05). The level of TP on postoperative day 7 was significantly higher than that on postoperative day 1 and postoperative day 3(P<0.05). The PA level on the third day after surgery was significantly lower than that on the first day after surgery(P<0.05). The Hb level on the 7th and 3rd day after surgery was significantly lower than that on the 1st day after surgery (P<0.05). The level of L decreased significantly in each group after surgery compared with the level before surgery(P<0.05), and gradually increased in each group after surgery, with significant difference among each two groups (P<0.05). Compared with preoperative value, blood Scr was significantly decreased in all groups after surgery (P<0.05), the UA level after surgery was significantly lower than the preoperative level in all groups(P<0.05), and at the 3rd day after surgery was significantly lower than at the 1st day after surgery(P<0.05). After surgery, the eGFR_EPI_c level was significantly higher than the level before surgery in all groups (P<0.05), and at the 7th day after surgery was significantly higher than at the 1st day after surgery (P<0.05). The level of WBC in all patients after surgery was significantly higher than that before surgery(P<0.05), and the level at the 3rd and 7th day after surgery was significantly higher than that at the 1st day after surgery(P<0.05). At the 7th day after surgery, the energy and protein intakes of the patients were significantly lower than the recommendations. There was positive correlation between preoperative BMI and TP, ALB levels at the 1st postoperative day and the TP level at 3rd postoperative day(P<0.05). There was no direct correlation between preoperative BMI and the length of postoperative hospital stay (P>0.05). The length of postoperative hospital stay was negatively correlated with the age and negatively with TP and ALB levels at the 1st postoperative day(P<0.05). CONCLUSIONS: Early postoperative nutritional status of patients with malignant oral and maxillofacial neoplasms complicated with diabetes mellitus decreased significantly. The energy and protein intakes of the patients are significantly lower than the recommendations. The length of postoperative hospital stay is negatively correlated with early postoperative nutritional status and age.