Application Of Enhanced Recovery After Surgery Programme Combined With Immunonutrition Therapy In Patients With Acute Abdomen

Background and objectiveEnhanced recovery after surgery(ERAS)can effectively reduce surgical stress,improve organ function,reduce postoperative complications,and accelerate patient recovery.Acute abdomen is the most common surgical emergency,usually with acute abdominal pain as the main clinical manifestation,accompanied by systemic reaction,often requiring surgical intervention.Malnutrition and immunosuppression caused by perioperative oral intake disorders,surgical stress,etc.in patients with acute abdomencan significantly increase the risk of postoperative adverse events and lead to prolonged hospital stay.In recent years,immunonutrient-rich nutritional preparations have been introduced into clinical practice and are widely used in non-ERAS environments.There have been some studies at home and abroad to speed up the recovery of immune nutrition combined with surgical clinical application,and have achieved good results.This study will further explore the effect of accelerated rehabilitation surgery combined with immunonutrition on immune function in patients with acute abdomen.MethodsAccording to the method of continuous sampling,the first affiliated to Zhengzhou University was collected from March 2017 to March 2018 for acute abdomen(gastrointestinal perforation,acute intestinal obstruction,intestinal necrosis,acute suppurative cholecystitis).Patients in the hospital and undergoing emergency surgery were divided into enteral immunonutrition(EIN)group and enteral standard nutrition(EN)group according to random number method.Two groups of patients perioperative treatment measures are used in enhanced recovery after surgery(ERAS),and 6 hours after the beginning of water,24 hours after the beginning of eating,and enteral nutrition.The EIN group was given an immunonutrient preparation,and the EN group was given an ordinary enteral nutrition preparation.And the serum levels of ALB,PA,CD4+,CD4+/CD8+,IgA,IgG and IgM were measured in preoperative and postoperative,and the incidence of postoperative complications and postoperative hospital stay were recorded.Statistical analysisStatistical analysis was performed using SPSS21.0.Measurement data are expressed as mean difference±standard deviation((?)±s).Inter-group and intra-group compared using two independent sample t-tests.Comparison of inter-group rates and comparison of count data using?~2 test.Comparison of repeated measures using variance analysis.The difference was statistically significant at P<0.05.ResultsThere was no statistical difference in the disease composition between the two groups(?~2=0.073,P=0.995).There were no significant differences in age,gender composition,preoperative NRS2002 nutritional score,peritonitis score,and surgical procedure between the two groups(P>0.05).There was no significant difference in the levels of ALB,PA,CD4+,CD4+/CD8+,IgA,IgG and IgM between the two groups before and 1 day after operation(P>0.05),but the indexes of the two groups were lower than those before the operation.no significant difference.On the 5th and7th day after operation,the above indexes were higher in the two groups,and the EIN group was more significant.The difference was statistically significant(P>0.05).Compared with the EN group,the incidence of postoperative infection,incisional rupture and anastomotic leakage was lower in the EIN group,and the postoperative hospital stay was shorter,the difference was statistically significant(P<0.05),but there was no significant difference in postoperative gastrointestinal reactions between the two groups.(P>0.05)ConclusionsThe combination of immunonutrition and enhanced recovery after surgery program for patients with acute abdomen can more effectively alleviate the patient's stress response,improve the nutritional status and the immune function of patients,reduce the incidence of postoperative complications,shorten the length of hospital stay and accelerate the recovery of patients.