| Objective:To explore the effects of whole-course nutrition management,including nutrition-related nursing and health education,reasonable nutrition support program,standardized blood glucose monitoring and exercise program,on blood glucose,nutrition-related indexes,satisfaction and quality of life of patients with pancreatic cancer.Methods:A research group on integrated nutrition support group for pancreatic cancer related medical technology and nursing was established.Patients hospitalized for pancreatic cancer in a Class A hospital in Wuhan from June to December 2020 were selected as the research subjects.Inclusion criteria were:(1)pancreatic cancer patients diagnosed by CT;(2)Age≥18 years old;(3)≤70 years old;(4)resection of pancreatic cancer is planned;(5)NRS2002 Nutritional Risk Screening Scale≥3 points;(6)No gastrointestinal tract related digestive system diseases,can implement enteral nutrition.Exclusion criteria:(1)non-pancreatic cancer;(2)complicated with serious complications;(3)gastrointestinal dysfunction,unable to carry out enteral nutrition.Nutritional status(body weight,BMI,blood sugar),laboratory indicators(albumin,pre-albumin,etc.),incidence of postoperative complications,quality of life scale and other objective indicators were used to collect data from the subjects.Patients with pancreatic cancer who were treated in a Class A hospital in Wuhan from June to August 2020 and met the standard of sodium discharge were selected as the control group.The control group received general diet health education and general perioperative nutrition management nursing.Patients with pancreatic cancer who received treatment in the same hospital from September to December 2020 and met the standards of NAS were selected as the experimental group,and the preliminary experiment was conducted from September to October 2020.The contents of the pre-experiment include:to evaluate the nutritional status of patients,and to develop individualized nutrition and related nursing programs.Patients who met the inclusion and exclusion criteria received a full-course dietary intervention from admission to two months after discharge.According to the situation of the experiment,the patients in the experimental group were finally given professional individualized and whole-course nutrition and nursing plan during hospitalization(preoperative,intraoperative and postoperative monitoring and intervention of patients’nutritional status).Body weight,BMI,blood glucose,albumin concentration,prealbumin concentration,incidence of postoperative complications,and quality of life scale scores of 2 groups were measured.SPSS 21.0 statistical software was used for corresponding data scientific statistics and analysis.Enumeration data was described as the number of cases(n).The measured data conforming to the normal distribution and homogeneity of variance were described as mean s standard deviation(X s),and the t-test was used for comparison between groups.Median test was performed on the measured data that did not conform to the normal distribution,and the quaternary was described by Mann-Whitney U test(P<0.05).Results:1.In the comparison of general information(age,weight,BMI,etc.)between the two groups,P>0.05 was not statistically significant,indicating that the two groups were comparable;2.Comparison of preoperative fasting blood glucose,postoperative fasting blood glucose,abnormal preoperative tolerance and abnormal postoperative blood glucose tolerance between the two groups(1)There was no significant difference in preoperative fasting blood glucose between the control group(6.30±1.16)and the experimental group(6.12±1.40)(t=0.715,P=0.477).(2)The difference in postoperative fasting blood glucose between control group(7.67±3.11)and experimental group(6.30±1.16)was statistically significant(t=-2.475,P=0.016).(3)There was no significant difference in the abnormal blood glucose tolerance between the control group(15 cases,41.7%)and the experimental group(14 cases,38.9%)(X~2=0.058,P=1.000).(4)The difference of abnormal blood glucose tolerance between control group(20cases,55.5%)and experimental group(6 cases,16.7%)was statistically significant(X~2=11.799,P=0.001).3.Comparison of nutritional indicators(1)Before treatment,there were no statistical differences in albumin(p-value=0.951),prealbumin(p-value=0.703)and lymphocytes(p-value=0.429)between the experimental group and the control group,and the baseline was comparable(2)After treatment,the pre-albumin of the experimental group(231.39±33.54,)was significantly higher than that of the control group(210.47±32.62,),and the difference was statistically significant(t=7.195,p-value=0.009).(3)Lymphocytes in the experimental group(1.82±0.47)were significantly higher than those in the control group(1.34±0.63).The difference was statistically significant(t=13.134,p-value=0.001).(4)The albumin of the experimental group(43.20±3.98,)was significantly higher than that of the control group(40.61±3.36,),and the difference was statistically significant(t=9.146,p-value=0.003).4.Comparison of quality of life between the two groups(QLICP-PA scale)(1)There was no significant difference in the physical function before treatment between the control group(49.22±11.12)and the experimental group(48.78±11.75)(t=-0.165,P=0.87).The physical function of the control group(52.61±9.48)after treatment was significantly different from that of the experimental group(58.17±5.87)(t=2.989,P=0.004).(2)There was no significant difference in mental function between the control group(58.31±8.37)and the experimental group(58.03±9.67)(t=-0.130,P=0.897).After treatment,the psychological function of patients in the control group(54.78±9.2)was significantly different from that in the experimental group(68.72±8.1)(t=6.824,P<0.001).(3)There was no significant difference in social function between the control group(63.83±5.75)and the experimental group(64.89±6.24)before treatment(t=0.747,P=0.458).The social function of the control group(69.89±3.42)after treatment was significantly different from that of the experimental group(74.36±8.21)(t=3.017,P=0.004).(4)The common symptoms and side effects in the control group(57.31±4.25)after treatment were significantly different from those in the experimental group(47.56±10.55)(t=-5.142,P=<0.001).5.Comparison of postoperative complications showed that the incidence of pancreatic fistula in the control group(16 cases,44.4%)was significantly lower than that in the experimental group(4 cases,11.1%),and the difference was statistically significant(X~2=9.969,P=0.003).Pancreatic fistula was significantly different between the groups.Gastric emptying disorder(10 cases),infection(1 case),and the incidence rate was the same in the two groups.There was no difference between the experimental group(4 cases)and the control group(4 cases)(X~2=0.127,P=1.000).6.Comparison of patient satisfaction between the two groupsAt discharge,the satisfaction of patients in the control group was 88.11±4.874points,and that in the experimental group was 98.08±1.746 points.The satisfaction score of patients in the experimental group was higher than that in the control group,and the difference between the groups was statistically significant and significant(P<0.001).Patients in the two groups were readmitted 2 months after surgery.The satisfaction of patients in the control group was 87.92±3.706 points,and the satisfaction of patients in the experimental group was 98.08±1.746 points.The satisfaction score of patients in the experimental group was higher than that in the control group,and the difference between groups was statistically significant and significant(P<0.001).Conclusion:Line for surgery in patients with pancreatic cancer preoperative nutritional risk screening and formulate and implement all the intensification of nutrition management,according to the different nutritional status of patients,nutritional requirements,combined with objective standards and indications,basis,targeted for scientific nutrition management,embodies the precise medical and elaborating the concept of nursing,to enhance the team members of professional knowledge and professional skills.1.Pancreatic patients have a high risk of nutritional risk screening,and increased nutritional demand after surgery can further increase the risk of malnutrition and aggravate the degree of malnutrition;2.Nursing and health education,reasonable nutrition support program,standardized blood glucose monitoring and exercise program can improve the nutritional status of pancreatic cancer patients.3.Whole course nutrition management can reduce postoperative blood glucose fluctuations and promote early bed movement of patients after pancreatic cancer surgery,which is in line with enhanced recovery after surgery(ERAS),can promote early postoperative recovery of patients,promote nutritional absorption,and can reduce postoperative complications(pancreatic fistula).4.Full-range nutrition and nursing programs can improve patients’quality of life and satisfaction. |
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