| Objective: The purpose of this study was to compare the tolerance difference between intestinal nutrient solution infusion at 37° C and normal temperature enteral nutrition solution to postoperative gastric cancer patients,and to explore the influence of normal temperature enteral nutrition solution on postoperative patients with gastric cancer,so as to provide reference for future clinical nursing work.Methods: Take the patients with gastrointestinal surgery in a tertiary Class A hospital in Wuhan from November 1,2018 to March 31,2019 as the research object,and the patients treated in the gastrointestinal Ⅰ area as the control group,Patients admitted to the gastrointestinal Ⅱ ward were used as the experimental group.The routine nursing and medical measures were the same between the two groups.The patients in the control group were heated to 37 ℃ by the infusion thermostat for infusion,and the patients in the experimental group were directly infused with normal temperature nutrient solution.The incidence of enteral nutrition intolerance,gastrointestinal related symptoms and mechanical complications were recorded.The nutritional and biochemical indexes,electrolyte indexes and inflammatory indexes of the two groups were recorded before operation,on the third day and on the seventh day after operation.The weight,BMI and grip strength of the subjects before and postoperative day 7 were recorded.The differences between the two groups in the incidence of enteral nutrition intolerance,the incidence of gastrointestinal complications and the incidence of mechanical complications were compared.The differences between the two groups in the nutritional and biochemical indexes,electrolyte indexes and inflammatory indexes at different time points(preoperative,postoperative day 3 and postoperative day 7)were compared.The differences between the two groups in the body weight,BMI and grip strength at different time points(before and postoperative day 7)were compared.Results: 1.Baseline data: There was no significant difference between the experimental group and the control group(P > 0.05).2.Tolerance: There was no significant difference in the incidence of enteral nutrition intolerance between the experimental group and the control group(P > 0.05),and there was no significant difference in the incidence of gastrointestinal symptoms(P > 0.05).3.Mechanical complications: There was significant difference between the experimental group and the control group(P < 0.05).Compared with the experimental group,the incidence of mechanical complications in the control group was significantly higher than that in the experimental group.4.Nutrition index: Nutrition indicators:(1)Comparison between groups: there was no significant difference in postoperative body weight,postoperative BMI,postoperative grip strength,and albumin,prealbumin,transferrin,retinol at different time points(P> 0.05).(2)Comparison within the group: before and after paired t-analysis and two factor repeated measurement analysis of variance showed that there were significant differences in weight,BMI and grip strength before and after operation.In the control group,serum albumin,serum prealbumin and retinol protein were significantly different on before operation and postoperative day 3(P < 0.01);serum albumin and transferrin were significantly different on before operation and postoperative day 7(P < 0.01);serum prealbumin and retinol protein were significantly different on the 3rd day and the 7th day after operation(P < 0.01).There was no significant difference in the changes of nutritional biochemical indexes at different time points.In the experimental group,there were significant differences in serum albumin,prealbumin,retinol protein and transferrin before and on the 3rd day after operation(P < 0.01);there were significant differences in serum albumin and transferrin before and on the 7th day after operation(P < 0.01);there were significant differences in serum albumin,prealbumin,transferrin on the 3rd day and on the 7th day after operation(P < 0.01)There was no significant difference in the changes of nutritional and biochemical indexes in other time points.5.Electrolyte index:(1)serum sodium: there was no significant difference between the test group and the control group at different time points(P > 0.05),that is,the normal temperature enteral nutrition solution did not affect the serum sodium level;the comparison of different time points in the group showed that there was no significant difference in the value of serum sodium between preoperative and postoperative days 3(P > 0.05),there was significant difference in serum sodium before and 7 days after operation and 3 days after operation and 7 days after operation(P < 0.001).(2)The time effect and intergroup effect p value of serum potassium were greater than 0.05(P > 0.05),that is,the change of serum potassium with time was not statistically significant,and the difference of serum potassium at different time points was not statistically significant(P > 0.05).Therefore,the normal temperature enteral nutrition solution did not affect the change of serum potassium.(3)There was no significant difference between the two groups(P = 0.087);the time effect P was less than 0.01(P < 0.01),that is,the serum calcium changed with time,specifically the change of serum calcium before and on the third day after operation and on the third and seventh day after operation was significant(P<0.01)。(4)There was no significant difference between the test group and the control group at different time points when the inter group effect p value of serum chlorine was greater than 0.05(P > 0.05);the time effect p value was less than 0.01(P < 0.01),that is,the value of serum chlorine changed with the change of time,in which the change of serum chlorine was statistically significant before and 3 days after operation,3 days after operation and 7 days after operation(P < 0.01)。 6.Inflammation index: intergroup effect(P > 0.05),that is,there was no significant difference in leukocyte value between the experimental group and the control group at different time points.In the comparison before and after the operation,the leukocytes in the control group had statistical significance(P < 0.01)between the preoperative and postoperative 3 days,preoperative and postoperative 7 days,postoperative 3 days and postoperative 7 days,and the leukocytes in the postoperative 7 days were still higher than the normal value.The difference of leukocytes in the experimental group was statistically significant(P < 0.05)before and on the 3rd day,and on the 3rd and 7th day after operation,but there was no statistical significance(P > 0.05)between the preoperative and the 7th day,and the leukocytes recovered to normal level on the 7th day after operation.Conclusions: 1.Compared with intestinal nutrient solution warmed to 37 ℃,normal temperature enteral nutrient solution infusion will not increase the incidence of enteral nutrition intolerance in patients with gastric cancer after operation;2.Compared with the enteral nutrition solution warmed to 37 ° C,normal temperature enteral nutrition solution infusion will not cause gastrointestinal related symptoms in patients with enteral nutrition after gastric cancer surgery;3..Compared with intestinal nutrient solution warmed to 37 ° C infusion,normal-temperature enteral nutrient solution can reduce the rate of extubation and blockage of the nasal bowel tube after gastric cancer surgery,and can reduce patient discomfort;4.Normal temperature enteral nutrition solution will not affect the absorption of patients with enteral nutrition after gastric cancer;5.Enteral nutrition solution at normal temperature has no effect on electrolytes in patients with enteral nutrition after gastric cancer surgery;6.Compared with intestinal nutrient solution warmed to 37 ° C infusion,the inflammation level of patients with enteral nutrition after gastric cancer infusion of normal temperature nutritional solution recovered faster. |
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