目的 探索基于营养不良三级诊断模型的多模式预康复干预对结直肠癌患者营养状态、胃肠功能以及预后恢复的 影响。 方法 依据纳入、排除标准选取西安市西安医学院第二附属医院 2021 年 3 月至 2024 年 3 月期间收集的 224 例结直肠癌 患者为本次研究对象,其中 4 例失访,最终汇总统计了 220 例结直肠癌患者预后情况。 按照随机数字表法及密封信封技术将 研究对象分为两组,对照组 110 例采用常规康复干预,试验组 110 例进行基于营养不良三级诊断模型的多模式预康复干预。 在干预 30 d 后,比较两组血清营养指标、体格和体能检查、胃肠屏障功能、欧洲癌症研究与治疗组织生活质量问卷核心 30( QLQ-C30)评分,同时统计住院期间术后并发症发生率。 结果 两组患者经相应干预 30 d 后,血清营养指标、体格和体能检查 结果、胃肠屏障功能、EORTC QLQ-C30 评分均较同组干预前有所改善(P<0. 05)。 而两组干预后比较,试验组干预后 30 d 的 血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、二胺氧化酶(DAO)、内毒素(ET)、血浆 D-乳酸(D-LAC)改善情况优于对照组 (P<0. 05),体质指数(BMI)、上臂肱三头肌皮褶厚度(TSF)、上臂肌围(AMC)指标以及 QLQ-C30 各因子评分值均高于对照组 (P<0. 05)。 同时,试验组术后并发症发生率(2. 73% 比 13. 64%)也低于对照组(P<0. 05)。 结论 基于营养不良三级诊断模型 的多模式预康复能够改善结直肠癌患者术后肠道屏障功能和营养状态,降低相关并发症,提高生活质量,对术后恢复具有显 著意义。

Objective Explore the impact of a multimodal pre-rehabilitation intervention based on a tertiary diagnostic model of malnutrition on nutritional status gastrointestinal function and prognosis recovery in patients with colorectal cancer. Method According to the inclusion and exclusion criteria 224 colorectal cancer patients collected from the Second Affiliated Hospital of Xi'an Medical University between March 2021 and March 2024 were selected as the subjects of this study. Four of them were lost to follow-up. The final prognosis of 220 colorectal cancer patients. Follow the principle of sealed envelope method conduct random sampling for grouping it was divided into 2 groups. In the control group 110 patients were treated with a conventional rehabilitation intervention the observation group of 110 patients underwent a multimodal pre-rehabilitation intervention based on a tertiary diagnostic model of malnutrition. Two groups at 30 d after the intervention comparing the serum nutritional index physical and physical examination gastrointestinal barrier function and quality of life scale QLQ - C30 scores at the same time the incidence of postoperative complications during hospitalization was counted. Result After 30 d of corresponding intervention serum nutritional index physical and physical examination results gastrointestinal barrier function and QLQ-C30 scores improved compared with the same intervention P < 0. 05 . Comparing the two groups after intervention the improvement of Hb TP ALB DAO ET and D-LAC at 30 d after intervention was better than the control group P <0. 05 BMI TSF AMC and QLQ-C30 score scores were higher than the control group P <0. 05 and the postoperative complication rate 2. 73% vs 13. 64% was also lower than that of the control group P <0. 05 . Conclusion Multimodal pre-rehabilitation based on the tertiary diagnostic model of malnutrition can improve the postoperative intestinal barrier function and nutritional status of colorectal cancer patients reduce related complications and improve the quality of life which has significant significance for postoperative recovery.