摘要
目的研究术前运动型饮料干预联合早期营养支持对腹腔镜直肠癌术后患者胃肠功能恢复及炎症水平的影响。方法选取2022年1月到2023年1月来驻马店市中心医院接受腹腔镜手术治疗的60例直肠癌患者,采用随机数字表法分为营养支持组和联合干预组,每组30例。营养支持组在术前给予患者早期营养支持,联合干预组在早期营养支持的基础上于术前服用运动型饮料。检测两组患者术后胃肠功能恢复情况,不良反应和并发症发生情况,检测患者术前1 d、术后2 d和8 d的血清转铁蛋白(TRF)、前白蛋白(PA)、血清白蛋白(ALB)水平评估患者营养情况,检测术前1 d、术后2 d和8 d两组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C-反应蛋白(CRP)水平,评估患者的炎症反应水平,比较两种干预方式的临床效果。结果联合干预组患者术后肠鸣音恢复时间、首次排气时间、首次排便时间和住院时间均明显短于营养支持组,差异具有统计学意义(P<0.05)。术前1 d,两组患者的营养指标(TRF,ALB,PA)比较,差异无统计学意义(P>0.05)。术后2 d、术后8 d两组TRF、ALB、PA水平均低于术前1 d,而术后8 d两组TRF、ALB、PA水平高于术后2 d,差异具有统计学意义(P<0.05);联合干预组术后2 d和8 d的TRF,ALB,PA水平明显高于营养支持组,差异有统计学意义(P<0.05)。术前1 d,两组患者的血清炎症因子(TNF-α、IL-6、IL-8、CRP)水平比较,差异无统计学意义(P>0.05)。术后2 d和8 d两组TNF-α、IL-6、IL-8、CRP水平均高于术前1 d,而术后8 d两组TNF-α、IL-6、IL-8、CRP水平低于术后2 d,差异具有统计学意义(P<0.05);联合干预组术后2 d和8 d的TNF-α、IL-6、IL-8、CRP水平均低于营养支持组,差异具有统计学意义(P<0.05)。两组不良反应及并发症发生情况比较,差异无统计学意义(P>0.05)。结论术前运动饮料干预联合早期肠内营养支持,能够促进患者术后胃肠功能恢复,改善直肠癌患者术后营养情况,缓解患者术后炎症反应水平,值得临床使用。
Objective To study the effects of preoperative sports drink intervention combined with early nutritional support on gastrointestinal function recovery and inflammatory levels in patients after laparoscopic rectal cancer surgery.Methods A total of 60 patients with rectal cancer who underwent laparoscopic surgery at Puyang City Central Hospital from January 2022 to January 2023 were selected.Patients were randomly assigned to either the nutritional support group or the combined intervention group,with 30 patients in each group.The nutritional support group received early nutritional support preoperatively,while the combined intervention group consumed a sports drink in addition to early nutritional support.The postoperative recovery of gastrointestinal function,adverse reactions,and complications were assessed.Serum levels of transferrin(TRF),prealbumin(PA),and serum albumin(ALB)were measured at 1 day before surgery,and 2 and 8 days after surgery to evaluate nutritional status.Serum levels of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),and C-reactive protein(CRP)were measured at the same time points to assess inflammation levels,comparing the clinical effects of the two intervention methods.Results The combined intervention group had significantly shorter times for recovery of bowel sounds,first flatus,first bowel movement,and hospital stay compared to the nutritional support group(P<0.05).On the day before surgery,there were no significant differences in nutritional indicators(TRF,ALB,PA)between the two groups(P>0.05).Both groups showed decreased levels of TRF,ALB,and PA at 2 and 8 days post-surgery compared to the day before surgery,with levels at day 8 being higher than those at day 2(P<0.05).The levels of TRF,ALB,and PA in the combined intervention group were significantly higher than those in the nutritional support group at 2 and 8 days post-surgery(P<0.05).On the day before surgery,there were no significant differences in serum inflammatory factors(TNF-α,IL-6,IL-8,CRP)between the groups(P>0.05).After surgery at days 2 and 8,levels of TNF-α,IL-6,IL-8,and CRP were higher than those on the day before surgery,and levels at day 8 were lower than at day 2(P<0.05).The combined intervention group had lower levels of TNF-α,IL-6,IL-8,and CRP at days 2 and 8 post-surgery compared to the nutritional support group,with significant differences(P<0.05).There were no significant differences in the incidence of adverse reactions and complications between the two groups(P>0.05).Conclusion The combination of preoperative sports drink intervention and early enteral nutritional support can promote recovery of gastrointestinal function in patients following rectal cancer surgery,improve nutritional status,and alleviate postoperative inflammatory responses,making it worthy of clinical application.
作者
付玉平
冯小霞
FU Yuping;FENG Xiaoxia(Department of Gastrointestinal Surgery,Puyang City Central Hospital,Puyang Henan 463000,China)
出处
《临床研究》
2025年第1期178-182,共5页
Clinical Research
关键词
腹腔镜
直肠癌
运动型饮料干预
早期营养支持
炎症因子
胃肠功能
Laparoscopy
Rectal cancer
Sports drink intervention
Early nutritional support
Inflammatory factors
Gastrointestinal function
