ERAS早期进食护理策略对胃癌术后康复影响.docxVIP

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ERAS早期进食护理策略对胃癌术后康复影响

【摘要】目的：探讨ERAS早期进食护理策略对胃癌患者术后康复的影响。方法：采用前瞻性随机对照研究，将66例胃癌手术患者分为ERAS组（33例）和对照组（33例）。ERAS组实施术后早期进食方案，包括术后6小时饮清水、术后第1天进清流质并逐步过渡；对照组采用传统禁食待排气后进食方法。比较两组术后肠道功能恢复时间、营养指标（白蛋白、前白蛋白）、炎症指标（C反应蛋白）、并发症发生率及住院时间。结果：ERAS组术后首次排气时间、排便时间、首次进食时间及住院时间均显著短于对照组（P0.001）。ERAS组营养指标显著优于对照组，C反应蛋白水平显著降低（P0.05）。ERAS组并发症发生率为12.1%，显著低于对照组的30.3%（P=0.034）。结论：ERAS早期进食策略可有效促进胃癌术后患者肠道功能恢复，改善营养状况，减轻炎症反应，降低并发症发生率，缩短住院时间，是一种安全有效的围手术期护理方案，值得临床推广。

【关键词】ERAS；早期进食；胃癌术后；康复护理

Abstract:Objective:ToexploretheimpactofearlyfeedingnursingstrategiesinERASonthepostoperativerecoveryofpatientswithgastriccancer.Methods:Aprospectiverandomizedcontrolledstudywasconducted,dividing66patientsundergoinggastriccancersurgeryintoanERASgroup(33cases)andacontrolgroup(33cases).TheERASgroupimplementedanearlypostoperativefeedingplan,includingdrinkingwater6hoursaftersurgery,consumingclearliquidonthefirstpostoperativedayandgraduallytransitioning;thecontrolgroupadoptedthetraditionalfastinguntilflatusmethodbeforefeeding.Therecoverytimeofintestinalfunction,nutritionalindicators(albumin,prealbumin),inflammatoryindicators(C-reactiveprotein),complicationrateandhospitalstaywerecomparedbetweenthetwogroups.Results:Thetimetofirstflatus,firstdefecation,firstfeedingandhospitalstayintheERASgroupweresignificantlyshorterthanthoseinthecontrolgroup(P0.001).ThenutritionalindicatorsintheERASgroupweresignificantlybetterthanthoseinthecontrolgroup,andtheC-reactiveproteinlevelwassignificantlylower(P0.05).ThecomplicationrateintheERASgroupwas12.1%,significantlylowerthan30.3%inthecontrolgroup(P=0.034).Conclusion:TheearlyfeedingstrategyinERAScaneffectivelypromotetherecoveryofintestinalfunctioninpatientsaftergastriccancersurgery,improvenutritionalstatus,reduceinflammatoryresponse,lowerthecompl