粗纤维食物结合肠营养支持对老龄直肠癌患者术后便秘的预防

Prevention of postoperative constipation in elderly patients with rectal cancer by crude fiber food combined with enteral nutrition

中文关键词:  肠内营养  肠外营养  粗纤维  直肠癌  便秘

英文关键词:enteral nutrition  parenteral nutrition  crude fiber  rectal cancer  constipation

中文摘要:

      目的 探究粗纤维食物结合肠营养支持对老龄直肠癌患者术后便秘的预防。方法 回顾性分析2014年10月至2017年6月我院收治的老龄直肠癌患者94例, 患者均经直肠癌根治性切除术, 根据患者所采取的术后营养支持方案不同分为研究组与对照组, 其中对照组(n=46)采取肠内联合肠外营养支持, 而研究组(n=48)则在此基础上结合粗纤维食物。比较两组患者的营养相关指标、排便次数及时间以及排便状况。结果 手术前、后2组患者的血清总蛋白(total protein, TP)、前清蛋白(prealbumin, PA)、转铁蛋白(transferrin, TF)等各营养相关指标水平均无明显差异(P>0.05); 研究组患者的术后首次排便时间与排便所需时间均明显低于对照组患者, 而每周排便次数则明显高于对照组患者(P<0.05); 与对照组患者相比, 研究组患者出现排便费力、粪质坚硬、腹胀、排便时血压不平稳、排便时血氧饱和度降低等状况的发生率明显更低(P<0.05)。结论 对于高龄直肠癌患者, 粗纤维食物结合肠营养支持能有效改善患者的术后排便状况, 预防术后便秘效果好, 具有一定的临床应用价值。

英文摘要:

      Objective To investigate the prevention of postoperative constipation in elderly patients with rectal cancer by combining crude fiber food with enteral nutrition support. Methods A retrospective analysis of 94 elderly patients with rectal cancer admitted to our hospital from October 2014 to June 2017 was performed. All patients underwent radical resection of rectal cancer. According to the postoperative nutritional support method adopted by the patients, they were divided into study group and control group. The control group (n=46) was treated with enteral combined with parenteral nutrition, while the study group (n=48) was combined with crude fiber food. Nutrition-related indicators, frequency and duration of bowel movements, and defecation status were compared between the 2 groups. Results There were no significant differences in serum total protein (TP), prealbumin (PA), transferrin (TF) and other nutrient-related indicators between the 2 groups before and after surgery (P>0.05). The time of first defecation and defecation in the study group was significantly lower than that in the control group, while the number of bowel movements per week was significantly higher than that of the control group (P<0.05). The incidence of defecation, hard stool, abdominal distension, unstable blood pressure during defecation, and decreased oxygen saturation during defecation were significantly lower in the study group comparing with the control group (P<0.05). Conclusion For elderly patients with rectal cancer, crude fiber food combined with enteral nutrition support can effectively improve the postoperative defecation condition of patients, prevent constipation after surgery, thus it has a good clinical application value.