摘要
目的 探讨不同营养支持方案对有营养风险肝脏手术患者预后的影响.方法 采用队列研究的方法,连续定点采集2021 年 1 月—2023 年 12 月在郴州市第一人民医院行手术治疗的 286 例肝脏外科患者的临床资料,根据围手术期采用的不同营养支持方案 1、方案 2、方案 3、方案 4 将NRS2002 评分≥3 分的患者分成 4 个队列(方案 1、方案 2、方案 3、方案 4 组各占 61、76、78、71 例),分析不同营养支持方案对存在营养风险患者住院时间、感染性并发症发生率和住院费用方面的影响.结果 共发生感染性并发症 17 例(5.94%),方案 1、方案 2、方案 3、方案 4 各占 3 例(4.92%)、3 例(3.95%)、4 例(5.13%)、7 例(9.86%).4 组患者住院时间分 别 为(10.97±6.31)d、(11.72±5.64)d、(11.68±7.31)d、(12.49±9.47)d,差异无统计学意义(P＞0.05);住院费用分别为(41 842.76±24 231.49)元、(39 467.46±23 491.75)元、(33 761.46±14 983.73)元、(31 448.61±16 911.87)元,方案1要明显高于其他 3 种方案(P＜0.05).NRS2002 评分≥3 分且＜5 分的患者中,接受营养支持方案 1、方案 2、方案 3、方案 4 患者的住院时间、感染性相关并发症发生率比较,差异无统计学意义(P＞0.05).方案 1 患者住院费用高于其他方案(P＜0.05).NRS2002 评分≥5 分的患者中,接受营养支持方案 1、方案 2、方案 3、方案 4 患者的感染性并发症发生率分别 6.25%(2/32)、2.70%(1/37)、5.56%(2/36)、13.33%(4/30),方案 4 患者的感染性并发症发生率高于其他方案(P＜0.05);方案 1 患者的住院费用高于其他方案(P＜0.05).结论 合理的营养支持方案可为患者可靠营养供给,降低潜在营养风险,减少感染性并发症风险,促进患者康复离院,该营养支持策略应用可行性较强.
Abstract
Objective Explore the impact of different nutritional support programs on the prognosis of liver surgery patients with nutritional risks.Methods Using a queue study method,clinical data of 286 liver surgery patients who underwent surgical treatment at the First People's Hospital of Chenzhou City from January 2021 to December 2023 were continuously collected at designated locations.Patients with NRS2002 scores≥3 points were divided into four queues based on different nutritional support schemes used during the perioperative period(scheme 1,scheme 2,scheme 3,and scheme 4 groups each accounted for 61,76,78,and 71 cases),and the effects of different nutritional support schemes on hospitalization time,incidence of infectious complications,and hospitalization costs of patients with nutritional risks were analyzed.Results A total of 17 cases(5.94%)of infectious complications occurred,with 3 cases(4.92%),3 cases(3.95%),4 cases(5.13%),and 7 cases(9.86%)of Scheme 1,Scheme 2,Scheme 3,and Scheme 4 respectively.The hospitalization time of the four groups of patients were(10.97±6.31)days,(11.72±5.64)days,(11.68±7.31)days,and(12.49±9.47)days,respectively,with no statistically significant difference(P>0.05);the hospitalization expenses were(41 842.76±24 231.49)yuan,(39 467.46±23 491.75)yuan,(33 761.46±14 983.73)yuan,and(31 448.61±16 911.87)yuan,respectively.Scheme 1 was significantly higher than the other three schemes(P<0.05).Among patients with NRS2002 scores≥3 points and<5 points,there was no statistically significant difference(P>0.05)in the length of hospital stay and incidence of infectious related complications among patients receiving nutritional support scheme 1,scheme 2,scheme 3,and scheme 4.The hospitalization expenses of patients in scheme 1 were higher than those in other plans(P<0.05).Among patients with NRS2002 scores≥5 points,the incidence of infectious complications in patients receiving nutritional support programs 1,2,3,and 4 was 6.25%(2/32),2.70%(1/37),5.56%(2/36)and 13.33%(4/30),respectively.The incidence of infectious complications in patients receiving program 4 was higher than that in other programs(P<0.05);The hospitalization expenses of patients in Plan 1 were higher than those in other plans(P<0.05).Conclusion A reasonable nutritional support plan can provide reliable nutrition supply for patients,reduce potential nutritional risks,minimize the risk of infectious complications,and promote patient recovery and discharge.This nutritional support strategy has strong feasibility for application.
维普
万方数据