摘要
目的 分析老年胃癌患者术后早期肠内营养支持治疗中持续质量改进护理模式应用效果，对患者预后影响。方法 以2023年9月-2025年11月入院接受根治手术治疗70例老年胃癌患者为研究对象，开展临床研究；术后均接受早期肠内营养支持，基于术前盲选抽签分组结果，术后予以对照组（n=35）常规护理，予以研究组（n=35）基于常规护理的持续质量改进护理。比较护理期间营养指标、术后胃肠功能恢复时间、肠内营养支持并发症发生率组间差异。结果 较对照组，研究组护理后前白蛋白（PA）、白蛋白（ALB）、血红蛋白（Hb）升高，且肠内营养支持并发症发生率降低，差异有统计学意义（P＜0.05）。较对照组，研究组护理后胃肠功能恢复时间及胃管留置时间缩短，差异有统计学意义（P＜0.05）。结论 老年胃癌患者术后早期肠内营养支持期间应用持续质量改进护理，可积极优化患者肠内营养支持治疗安全性、治疗效果，且可辅助促进术后胃肠功能恢复。
关键词： 老年患者；胃癌根治术；早期肠内营养支持；持续质量改进护理
Abstract
Objective To analyze the application effect of the continuous quality improvement nursing model in the early enteral nutrition support treatment for elderly patients with gastric cancer after surgery, and its impact on the prognosis of patients. Methods A total of 70 elderly patients with gastric cancer who underwent radical surgery from September 2023 to November 2025 were selected as the research subjects. A clinical study was carried out. All patients received early enteral nutrition support after surgery. Based on the preoperative blind selection and lottery grouping results, the control group (n=35) received routine care, and the research group (n=35) received continuous quality improvement nursing based on routine care. The differences in nutritional indicators during the nursing period, postoperative recovery time of gastrointestinal function, and incidence of enteral nutrition support complications between the two groups were compared. Results Compared with the control group, the research group showed an increase in Prealbumin (PA), Albumin (ALB), Hemoglobin (Hb) after nursing, and the incidence of enteral nutrition support complications decreased, with statistically significant differences (P<0.05). Compared with the control group, the recovery time of gastrointestinal function and the retention time of gastric tube in the research group were shortened after nursing, with statistically significant differences (P<0.05). Conclusion The application of continuous quality improvement nursing during the early enteral nutrition support period for elderly patients with gastric cancer can actively optimize the safety and treatment effect of enteral nutrition support treatment, and can also assist in promoting the recovery of postoperative gastrointestinal function.
Key words： Elderly patients; Radical gastrectomy for gastric cancer; Early enteral nutrition support; Continuous quality improvement nursing
参考文献 References
[1] 秦语欣,凌蓉. 基于循证的早期肠内营养支持护理对胃癌术后患者营养指数、免疫功能及生存质量的影响[J]. 中外医学研究,2025,23(20):113-117.
[2] 王楠,张召弟. 精准优质护理结合肠内营养干预在胃癌术后患者中的应用效果探讨[J]. 延边大学医学学报,2025, 48(5):166-168.
[3] 程婷婷,刘丽丽,于淑媛,等. 变革理论下护理对胃癌切除术后早期肠内营养支持患者营养指数及预后的影响[J]. 中国医药导报,2024,21(17):158-160,164.
[4] 胡小芳,李小娟,刘金明,等. 集束化护理模式在胃癌术后患者肠内营养支持中的应用观察[J]. 实用中西医结合临床,2025,25(9):112-115.
[5] 吕文静,胡玉娜. 基于目标导向的临床护理路径干预对胃癌术后患者实施早期肠内营养效果的影响[J]. 肿瘤基础与临床,2025,38(2):297-300.
[6] 彭红,连萍红,陈丰梅,等. 早期肠内营养支持联合针对性护理应用于胃癌合并糖尿病患者术后的效果及护理要点探讨[J]. 糖尿病新世界,2025,28(9):138-141.
[7] 范本杰,王丰男. 持续质量改进肠内营养护理管理模式对胃癌根治术后患者肠内营养耐受性、免疫功能及营养状态的影响[J]. 国际护理学杂志,2022,41(21):3948-3951.
[8] 刘扬,马沛,董艳萍. 质量改进模式下集束化护理应用于胃癌患者腹腔镜手术后肠内营养制剂治疗期间的效果[J]. 中国药物滥用防治杂志,2024,30(2):367-371.