| Objective: To explore the impact of individualized quantitative dietary guidance after discharge from hospital after gastric cancer surgery under the guidance of accelerated rehabilitation surgery(Enhanced Recovery After Surgery,ERAS)concept on the short-term nutritional status and quality of life of patients,help clinicians to formulate more perfect nutritional treatment measures,and provide reference for long-term nutritional continuation treatment after gastric cancer patients.Methods: This study retrospectively analyzed 76 patients who were hospitalized in our hospital from January 1,2018 to December 31,2019.According to the actual clinical implementation,39 postoperative patients with gastric cancer discharged from January 1,2018 to December 31,2018 were selected as the control group,and the postoperative patients with gastric cancer discharged from January 1,2019 to December 31,2019 were selected as the intervention group.Control group implemented routine dietary guidance program after gastric cancer operation,intervention group implemented individual quantitative dietary guidance program under ERAS guidance.Record two groups of body weight,body mass index(Body Mass Index,BMI),total protein(Total Protein,TP),albumin(Ablumin,ABL),hemoglobin(Hemoglobin,HB)preoperative and 3 months after discharge.Quality of Life Qusetionnaire Core 30(Version 3),(QLQ-C30(V3.0))and Quality of Life Qusetionnaire of Stomach22,(QLQ-STO22)as well as recorded 3 months after discharge.And compared the nutritional status and quality of life of the two groups.Result: 1、There was no significant difference in sex ratio,age,height,education,smoking history,drinking history,abdominal surgery history,complications,NRS2002 score between the two groups(P>0.05).2、There was no significant difference between the intervention group and the control group in tumor location,operation,resection range,pathological type and so on(P>0.05);However,in the pathological stage,the intervention group accounted for 16.2%,37.8% and 45.9% in stage I,II and III,respectively,and the control group accounted for 43.6%,25.6% and 30.8%,respectively.The proportion of patients with pathological stage II and III in the intervention group was higher than that in the control group,while the patients with pathological stage I were lower than the control group,and the difference was statistically significant(P<0.05).3、There was no significant difference in body weight,BMI,TB,ABL and HB between the intervention group and the control group in terms of nutritional indexes(p > 0.05).Three months after discharge,the body weight(55.67±8.55 kg VS 60.19±8.72kg)、BMI(22.12±2.30 kg/m2 vs 20.81±2.66 kg/m2),TB(68.60±4.45 g/l vs 63.04±7.05 g/l),ABL(41.18±3.39 g/l vs 36.46±5.67 g/l),HB(125.81±13.46 g/l vs 118.00±14.69 g/l)in the intervention group were significantly higher than those of the control group,p < 0.05.4、Three months after discharge from hospital,QLQ-C30(V3.0)questionnaire and QLQ-STO22 questionnaire were conducted for all patients involved.statistical analysis showed that: QLQ-C30(V3.0)questionnaire analysis showed that there was no significant difference in the role function,cognitive function,emotional function,social function,fatigue,pain,nausea and vomiting,shortness of breath,appetite,constipation,diarrhea,economic difficulties and other aspects between the two groups(P>0.05).compared with the control group,the intervention group had advantages in overall quality of life,body function,insomnia and the difference was statistically significant(p < 0.05)QLQ-STO22 questionnaire analysis showed that there was no significant difference in dysphagia,pain,reflux,eating disorders,dry mouth,taste changes,body image and alopecia between the two groups(p > 0.05),but in terms of anxiety,the symptoms of the control group were significantly more serious than those of the intervention group,and the difference was statistically significant(P < 0.05).Conclusion: Nutritional continuous therapy is also an important part of nutritional therapy for gastric cancer patients guided by the concept of accelerated rehabilitation surgery.The individualized quantitative diet guidance based on the theory of rapid rehabilitation surgery can improve the short-term nutritional status and improve the quality of life of patients. |
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