目的 探究营养预康复对老年腹部肿瘤手术患者临床预后的影响。 方法 回顾性收集 2021 年 3 月至 2021 年 12 月在 徐州医科大学附属医院普外科接诊的胃肠外科手术患者,依据门诊首诊时是否接受口服营养补充方式将观察对象分为两组,预 康复组(n= 40)采用营养预康复模式,对照组(n= 53)采用常规照护模式。 所有患者依据美国国家综合癌症网络(NCCN)指南进 行腹腔镜下手术治疗。 比较两组营养状况、并发症、心理状况、住院日和医疗花费指标变化。 结果 营养指标方面,预康复组体重 丢失量低于对照组[(-1. 88±0. 92) kg 比(-2. 56±0. 70) kg, P<0. 01],而血清总蛋白、血清白蛋白和血清前白蛋白指标变化两组 差异无统计学意义(P>0. 05);预康复组的感染率低于对照组(15. 00% 比 35. 85%, P= 0. 03),术中出血量两组差异无统计学意义 (P= 0. 19);在整个治疗过程中,预康复组住院日显著少于对照组[13. 0(11. 0,17. 8)d 比 15. 0(14. 0,19. 0)d, P= 0. 034],医疗花 费亦低于对照组[5. 93(4. 86,6. 88)万元比 6. 65(5. 44,7. 58)万元,P= 0. 028]。 结论 在老年腹部肿瘤手术患者中,营养预康复模 式可能有助于患者维持良好的营养状态,从而帮助降低感染率、降低住院费用、缩短住院时间。

Objective To explore the effect of nutrition pre-rehabilitation on the clinical prognosis of elderly patients undergoing abdominal tumor surgery. Method A retrospective study was conducted. Participants were divided into two groups according to whether they received oral nutritional supplementation at the first outpatient visit. The nutrition pre - rehabilitation group n = 40 adopted nutritional pre- rehabilitation mode while the control group n = 53 was treated with routine care - mode. All patients underwent laparoscopic surgery according to National Comprehensive Cancer Network guidelines. The changes of nutritional status complications psychological status hospitalization days and expenditures were compared between the two groups. Result The weight of the two groups were decreased while the index of the nutrition pre-rehabilitation group was better than the control group -1. 88±0. 92 kg vs -2. 56± 0. 70 kg P<0. 01 . Yet it is not suitable for the index of serum total protein serum albumin and serum prealbumin P>0. 05 . In addition the infection rate of pre-rehabilitation group was lower than that of control group 15. 00% vs 35. 85% P = 0. 03 and there was no difference in intraoperative bleeding p=0. 19 . At discharge the pre-rehabilitation group had significantly fewer hospitalization days 13. 0 11. 0 17. 8 days vs 15. 0 14. 0 19. 0 days P=0. 034 and expenditures 59 300 48 600 68 800 yuan vs 66 500 54 400 75 800 yuan P=0. 028 . Conclusion In elderly patients undergoing abdominal tumor surgery nutrition pre-rehabilitation model may help to maintain better nutritional status. In addition it may also reduce infection rate and expenditures as well as shorten hospitalization days.