围术期早期营养支持对改善喉癌全喉切除术老年患者免疫功能和生活质量的影响

Effects of early perioperative nutritional support on improving immune function and quality of life of elderly patients undergo-ing total laryngectomy for laryngeal cancer

中文关键词: 老年  喉癌  全喉切除术  营养支持  免疫功能  生活质量  T淋巴细胞

英文关键词: elderly  laryngeal cancer  total laryngectomy  nutritional support  immune function  quality of life  T lym-phocyte

中文摘要:

      目的 探讨围术期早期营养支持对改善喉癌全喉切除术老年患者免疫功能和生活质量的影响.方法 选择2023年1月 2024年1月复旦大学附属眼耳鼻喉科医院收治的90例因喉癌行全喉切除术的老年患者,随机分为观察组和对照组,每组45例.对照组予以常规静脉营养支持,观察组予以围术期早期营养支持,2组均持续干预2周.对比2组免疫功能、生活质量等指标值.结果 干预后,2组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均显著改善,且观察组上述指标改善优于对照组(P＜0.05);2组血红蛋白、血清白蛋白和前白蛋白水平均显著改善(P＜0.05),且观察组上述指标改善优于对照组(P＜0.05);2组T淋巴细胞CD3+、CD4+和CD4+/CD8+水平均显著改善(P＜0.05),且观察组上述指标改善优于对照组(P＜0.05);2组生活质量评分均显著改善(P＜0.05),且观察组生活质量评分高于对照组(P＜0.05).干预期间,观察组术后并发症总发生率显著低于对照组(P＜0.05),观察组平均住院时间短于对照组[(17.50±2.30)d vs(22.80±3.10)d),P＜0.05],住院总费用低于对照组[(4.85±0.5)万元 vs(5.82±0.67)万元,P＜0.05].结论 喉癌全喉切除术老年患者接受围术期早期营养支持可有效改善其营养状况、免疫功能、生活质量,并发症发生率低,住院时间短、费用少,具有一定的临床应用价值.

英文摘要:

      Objective To explore the effects of early perioperative nutritional support on improving immune function and quality of life of elderly patients undergoing total laryngectomy for laryngeal cancer.Methods 90 elderly patients under-going total laryngectomy for laryngeal cancer in Eye,Ear,Nose and Throat Hospital Affiliated to Fudan University between January 2023 and January 2024 were selected and randomly divided into control group and observation group,with 45 cases in each group.The control group received conventional intravenous nutritional support,while the observation group received early perioperative nutritional support.Both groups were intervened for 2 weeks.The values of immune function,quality of life,and other indicators were compared between two groups.Results After the intervention,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in both groups increased significantly,and the observation group was higher than the control group(P＜0.05);the levels of hemoglobin,serum albumin and prealbumin in both groups increased significantly(P＜0.05),and the observation group was higher than the control group(P＜0.05);the levels of CD3+,CD4+and CD4+/CD8+of T lymphocytes in both groups increased significantly,and the observation group was higher than the con-trol group(P＜0.05);the scores of quality of life in both groups increased significantly,and the observation group were high-er than the control group(P＜0.05).During the intervention period,the total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P＜0.05).The average hospital stay of the observa-tion group was shorter than that of the control group[(17.50±2.30)d vs(22.80±3.10)d),P＜0.05],and the total hos-pitalization cost was lower than that of the control group[(48 500±5 000)RMB vs(58 200±6 700)RMB,P＜0.05].Conclusion Early perioperative nutritional support for elderly patients undergoing total laryngectomy for laryngeal cancer can effectively improve their nutritional status,immune function,and quality of life.It has a low incidence of complications,short hospitalization time,and low cost,and has certain clinical application value.