| Objective: Through preoperative nutritional risk screening,enhanced recovery after surgery and routine treatment were adopted for colorectal cancer patients with nutritional risk,and the effects of two groups of different measures on postoperative nutritional status,immune function and rehabilitation indicators were analyzed.Methods: From December 2020 to December 2022,189 patients who received laparoscopic radical colorectal cancer surgery at the General Hospital of Ningxia Medical University were selected for nutritional risk assessment using NRS2002 after admission.The patients were divided into ERAS group(98 cases)and conventional group(91 cases)by random number table method.They were treated with enhanced recovery after surgery and conventional treatment during the perioperative period respectively.Using the propensity score matching analysis method,set the matching ratio as 1:1,and set the caliper value as 0.02.Based on 12 indicators,including preoperative NRS2002 score,gender,age,body mass index(BMI),whether there are basic diseases(hypertension,diabetes,coronary heart disease),operation mode,duration,blood loss,tumor pathological stage,and degree of differentiation,ERAS group and conventional group were paired.After matching,73 patients in each group were included in the matching study.The differences between ERAS group and conventional group in postoperative nutritional status and immune function level,postoperative rehabilitation indicators,complications,postoperative hospital stay and hospital expenses were recorded and analyzed.Results: HB,ALB,PAB and TRF in ERAS group were higher than those in the conventional group on the 3rd and 5th day after operation after using propensity score matching(P<0.05).The ratio of CD4/CD8 in ERAS group was higher than that in conventional group on the 3rd day after operation,and the ratio of CD8 was lower than that in conventional group.The results were statistically different(P<0.05);There was no statistical difference in the results of CD3,CD4,B cells and NK cells between the two groups(P>0.05).CD4,CD4/CD8 and B cells in ERAS group were higher than those in conventional group on the fifth day after operation,and CD8 was lower than that in conventional group.The results were statistically different(P<0.05);There was no statistical difference in the results of CD3 and NK cells between the two groups(P>0.05).The time of the first ventilation,the first defecation,the first drinking water and the first liquid feeding in the ERAS group were earlier than those in the conventional group,and the results were statistically different(P<0.001).There was no statistical difference in the incidence of postoperative complications between the two groups(P>0.05).The days of hospitalization in ERAS group were shortened by 1 day compared with that in the conventional group,the difference was statistically significant(P<0.001),and the total cost of hospitalization was lower than that in the conventional group,the difference was statistically significant(P<0.001).Conclusion: The application of enhanced recovery after surgery in the perioperative period of colorectal cancer patients with nutritional risk can improve postoperative nutritional status and immune function,promote the rapid recovery of patients without increasing the risk of postoperative complications,and bring good time and economic benefits. |
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