Effects Of Dietary Diary Management On Nutritional Status Of Postoperative Discharged Elderly Patients With Esophageal Cancer

Part I Investigation of nutritional status in postoperative discharged elderly patients with esophageal cancerObjectives:To understand and analyze the nutritional status,delayed rate of radiotherapy and chemotherapy and nutritional support of elderly patients with esophageal cancer at the time of discharge and the first postoperative follow-up.Methods:The medical records of 196 elderly patients with esophageal cancer who received surgical treatment in the thoracic surgery department of the Fourth hospital of Hebei Medical University from January 2018 to January 2019 were retrospectively analyzed.Results:1.The ratio of male to female in 196 patients was 2.44:1,with an average age of(66.35 ± 4.22)years.There were 19 cases(9.69%)in Ⅰ stage,110 cases(56.12%)in normal stage,62 cases(31.63%)in normal stage,and 5cases(2.55%)in normal stage.Histological types were squamous cell carcinoma in 116 cases(59.18%)and adenocarcinoma in 80 cases(40.82%);2.174(88.78%)patients lost weight at the first return visit,with an average weight loss of(4.34 ± 3.28)kg;3.Taking body mass index,serum albumin,serum prealbumin and hemoglobin as criteria for malnutrition assessment,the incidence of malnutrition was 4.08%,97.96%,91.84% and 82.14% at discharge,and 8.67%,51.53%,46.94% and 41.84% at first visit,respectively.There were significant differences in above indexes between patients at discharge and at the first return visit(P<0.05);4.Radiotherapy and chemotherapy were delayed in 6 patients;5.At discharge,153(78.06%)patients were at nutritional risk,196(100%)patients received nutritional support,and 134(68.37%)patients were at nutritional risk at the first return visit.The incidence of nutritional risk at the first return visit was significantly lower than that at discharge(P < 0.05).Conclusions:The incidence of malnutrition in elderly patients with esophageal cancer is high,and the nutritional status at the first follow-up visit after operation is still not optimistic,which will affect the process of radiotherapy and chemotherapy.Part II Effects of Dietary Diary Management on Nutritional Status of Postoperative Discharged Elderly Patients with Esophageal CancerObjectives:In this study,the dietary diary management program was adopted for elderly patients with esophageal cancer after operation,to compare the changes of nutritional status of elderly patients before and after intervention,and to explore the effect of this intervention on improving the nutritional status of elderly patients with esophageal cancer after operation.Methods:1.A total of 100 elderly patients with esophageal cancer who underwent surgery for the first time in the Department of Thoracic surgery of the Fourth Hospital of Hebei Medical University from February 2019 to October 2020 were selected as the object of study.Among them,50 patients from February2019 to October 2019 served as the control group,and 50 patients from November 2019 to October 2020 served as the experimental group.2.The patients in the control group received dietary guidance before discharge,and the patients in the experimental group received diet diary management program on this basis and training on diet diary recording method before discharge.3.The preparation for the intervention was carried out when the patient was discharged from the hospital,and the intervention time was up to one month after discharge.The body weight,body mass index,serum albumin,prealbumin,hemoglobin and nutritional risk of the two groups were observed and analyzed before and one month after intervention.4.The data were analyzed with SPSS 23.0,and the“P<0.05”indicated that there was statistically significant difference.Results:1.Before intervention,there was no significant difference in basic conditions and indexes between the test group and the control group(P>0.05);2.After one month of intervention,the body weight and BMI of patients in the experimental group and the control group decreased,but there was no significant difference in the reduction rate of body weight and BMI between the two groups(P>0.05).The weight and BMI of the experimental group were significantly lower than those of the control group(P<0.05);3.The levels of ALB and PAB in the experimental group and the control group were improved after intervention.The levels of ALB and PAB in the experimental group were significantly higher than those in the control group(P<0.05);there was no significant difference in Hb between the two groups(P>0.05);4.After intervention,the incidence of nutritional risk in the experimental group was 44.68%,and that in the control group was 66.00%,with significant difference between the two groups(P<0.05).Conclusions:1.The body weight and BMI of postoperative patients with esophageal cancer decreased,and the levels of serum albumin,prealbumin,hemoglobin and nutritional risk were improved.2.The application of diet diary management program in elderly patients discharged from hospital after esophageal cancer surgery can improve the body weight,body mass index,serum albumin,prealbumin,hemoglobin level and nutritional risk to a certain extent.However,the improvement effect on the level of hemoglobin is not obvious.