关键词: 加速康复外科, 老年人, 头颈癌, 营养管理, 胃肠道功能

Abstract: Objective To explore the application effects of nutrition management based on enhanced recovery after surgery(ERAS) in the elderly patients with head and neck cancer during the perioperative period. Methods The data of 81 patients who underwent head and neck cancer surgery at Nanjing Drum Tower Hospital from October 2022 to October 2023 were retrospectively collected and divided into control group(n=39) and experimental group(n=42). The control group received traditional nutritional support, whereas the experimental group received ERAS-based nutritional support. Postoperative recovery time, nutritional status one week after operation, incidence of complications and feeding tolerance were compared between the two groups. Results The experimental group had significantly shorter time for the first flatus passage, getting out of bed, and resuming oral intake, as well as lower hospitalization costs and length of stay compared to the control group(P<0.05). One week after surgery, the changes of albumin, prealbumin, transferrin, body mass index (BMI), body weight, fat-free mass, skeletal muscle, protein and body water content were significantly lower in the experimental group compared to those in the control group(P<0.05). The incidence rates of postoperative complications and the incidence rates of diarrhea, abdominal distension and constipation in the experimental group were lower than those in the control group(P<0.05). Conclusions Nutritional management based on the ERAS concept in elderly patients with head and neck cancer perioperatively can promote the recovery of gastrointestinal function, improve feeding tolerance and nutritional status, reduce the incidence of postoperative complications, accelerate recovery, shorten hospital stays, and improve the quality of life.

Key words: enhanced recovery after surgery, aged, head and neck cancer, nutritional management, gastrointestinal function