Application Of Nutritional Intervention Under MDT Mode In The Perioperative Period Of Elderly Patients With Digestive System Diseases

Objective: To investigate the effect of nutritional intervention under the multi-disciplinary treatment(MDT)mode on the prognosis and postoperative recovery of elderly patients with digestive tract diseases undergoing surgery in the perioperative period.Methods: A total of 109 elderly patients who underwent surgery for digestive tract diseases from January 2021 to January 2022 in the general surgery and minimally invasive surgery departments of People’s Hospital of Xinjiang Uygur Autonomous Region were selected and divided into MDT and non-MDT groups based on a 1:1 propensity score matching.Nutritional intervention under the multi-disciplinary treatment was implemented in 53 patients in the MDT group,while it was performed under the guidance of the attending physician in 56 patients in the control group.Differences in basic conditions,nutrition-related indicators and scores,inflammation indicators,biochemical indicators,health economic indicators,etc.were compared between the two groups 1 day before surgery,3 days after surgery and 7 days after surgery.Results: 1.Baseline data of patients: There was no statistically significant difference in gender,age,body measurements,and surgical levels between the two groups(P> 0.05),and they were not comparable.2.Nutritional status: The average level of total protein and albumin in MDT group decreased first and then increased at different time points before and after operation.The difference between the two indexes at three different time points in this group was statistically significant(P<0.05);The average level of total protein and albumin in patients in non-MDT group tended to decline at three different time points before and after operation.The difference between the two indicators in this group at three different time points was statistically significant(P<0.05).3.Inflammation index: The mean value of inflammatory index WBC,CRP and the constituent ratio of procalcitonin(PCT)<0.05 were compared between the two groups,and the difference was statistically significant(P<0.05);There were statistically significant differences between preoperative and postoperative inflammatory indexes of 25-hydroxyvitamin D(25-OH-VD)and PCT<0.05 in MDT group(P<0.05).There were statistically significant differences between preoperative and postoperative inflammatory indexes(25-OH-VD,CRP,IL-6,PCT<0.05 constituent ratio)in non-MDT group(P<0.05).4.Biochemical indexes: There were statistically significant differences between the two groups in liver function related indicators(AST,ALT mean level)after operation(P<0.05);There was a statistically significant difference between the preoperative and postoperative liver function related indexes(ALT,AST average level)in MDT group(P<0.05);The indexes related to renal function(BUN,Cr average level)of the two groups were compared,and the difference was statistically significant(P<0.05).5.Health economic indicators: The difference between the two groups was statistically significant(P<0.05).The number of patients with poor wound healing and bleeding in MDT group was lower than that in non-MDT group.Conclusion: Nutritional intervention under the MDT model during the perioperative period can effectively promote the recovery of elderly patients with digestive system diseases after surgery,reduce the incidence of infections and complications,and promote postoperative recovery.