外科手术室细节护理配合围手术期药食同源营养干预对降低术后感染率的效果分析OA
Effect analysis of detailed nursing in the operating room combined with food and medicine homology-based perioperative nutrition intervention on reducing postoperative infection rate
目的 探讨外科手术室细节护理配合围手术期药食同源营养干预对降低术后感染率的临床效果.方法 选取 2023年 1 月至 2024 年 12 月收治的 300 例外科手术患者,采用随机数字表法分为对照组和观察组,每组 150 例.对照组接受常规手术室护理及常规围手术期营养支持,营养方案为标准整蛋白型肠内营养制剂,不涉及药食同源成分;观察组实施手术室细节护理,并在常规能量/蛋白目标管理基础上联合药食同源营养干预及免疫增强型肠内营养支持.药食同源方由医院中药房按《中华人民共和国药典》标准统一配制,术前方以黄芪、党参、山药、薏苡仁等为主,术后方调整为黄芪、当归、茯苓、白术、陈皮等.本研究对患者和实施者未行盲法,但结局评价(感染判定、切口评价、实验室指标检测)均由不知晓分组信息的人员独立完成.比较两组术后感染发生率、免疫功能指标、营养状态指标、切口愈合情况及住院时间.结果 观察组术后感染发生率为 4.00%,显著低于对照组的 12.67%(P<0.05);观察组术后CD4+、CD4+/CD8+水平及血清白蛋白、前白蛋白水平均显著高于对照组(P<0.05);观察组切口甲级愈合率为 90.67%,高于对照组的 78.00%(P<0.05);观察组住院时间显著短于对照组(P<0.05).结论 手术室细节护理配合围手术期药食同源营养干预能有效降低术后感染发生率,改善免疫功能和营养状态,促进切口愈合,缩短住院时间,但受非盲法设计和单中心样本限制,结论尚需多中心研究进一步验证.
Objective To investigate the clinical effect of detailed nursing in the operating room combined with food and medicine homology-based perioperative nutrition intervention on reducing postoperative infection rate.Methods A total of 300 patients who underwent surgery admitted from January 2023 to December 2024 were enrolled and divided into a control group and an observation group using a random number table,with 150 in each group.The control group received routine nursing in the operating room and routine perioperative nutritional support,with the nutritional regimen being a standard whole-protein enteral nutrition formula,and no food and medicine homologous components were used;the observation group received detailed nursing in the operating room,and on the basis of routine energy/protein target management,additionally received food and medicine homology-based nutrition intervention and immune-enhancing enteral nutrition support.The food and medicine homology-based formula was uniformly prepared by the hospital's Chinese medicine pharmacy in accordance with the standards specified in the Chinese Pharmacopoeia.The preoperative formula mainly included Huangqi(Astragali Radix),Dangshen(Codonopsis Radix),Shanyao(Dioscoreae Rhizoma),and Yiyiren(Coicis Semen),and the postoperative formula was adjusted to mainly include Huangqi(Astragali Radix),Danggui(Angelicae Sinensis Radix),Fuling(Poria),Baizhu(Atractylodis Macrocephalae Rhizoma),and Chenpi(Citri Reticulatae Pericarpium).This study was not blinded for patients or implementers;however,outcome assessments(infection adjudication,incision evaluation,and laboratory index testing)were independently performed by personnel unaware of group allocation.Postoperative infection rate,immune function indices,nutritional status indices,incision healing,and length of hospital stay were compared between the two groups.Results The postoperative infection rate in the observation group was 4.00%,significantly lower than 12.67%in the control group(P<0.05).Postoperative CD4+and CD4+/CD8+levels and serum albumin and prealbumin levels in the observation group were significantly higher than those in the control group(P<0.05).The rate of grade A incision healing in the observation group was 90.67%,higher than 78.00%in the control group(P<0.05).The length of hospital stay in the observation group was significantly shorter than that in the control group(P<0.05).Conclusion Detailed nursing in the operating room combined with food and medicine homology-based perioperative nutrition intervention can effectively reduce postoperative infection rate,improve immune function and nutritional status,promote incision healing,and shorten length of hospital stay;however,due to the unblinded design and single-center sample limitations,the conclusions still need to be further verified by multicenter studies.
徐晶晶
北京市西城区广外医院(北京市西城区广外老年医院),北京 100055
医药卫生
手术室护理药食同源围手术期营养干预术后感染免疫功能
operating room nursingfood and medicine homologyperioperative nutrition interventionpostoperative infectionimmune function
《药食同源杂志》 2026 (2)
101-108,8
北京市西城区科技新星项目(XWKX2024-13).
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