Abstract:

Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery. Methods By convenience sampling method，46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group，while 49 patients admitted from January to June 2023 as a control group. The experimental group was administered with the refined early diet plan，and the control group was administered with conventional methods. The intervention period was from the first day after surgery to discharge. The differences of the first postoperative defecation time，perioperative thirst and hunger score，postoperative hospitalization time，hospitalization cost，postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups. Results 42 patients in the experimental group and 49 patients in the control group completed the study. First postoperative exhaust time（t=4.922，P<0.001），first postopera-tive defecation time（Z=-2.440，P=0.015），perioperative thirst score（Z=-8.024，P<0.001），perioperative hunger score （Z=-8.192，P<0.001），postoperative hospitalization time（Z=-7.622，P<0.001） and hospitalization cost（Z=-4.522，P<0.001） were lower than those of the control group，and the difference was statistically significant. There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group（P>0.05）. Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer，promoting intestinal function recovery，shortening hospital stay，reducing hospital costs，and improving patients’ subjective comfort.

Key words: Gastric Neoplasms, Gastrectomy, Laparoscopes Surgery, Early Oral Feeding, Nursing Care

摘要：

目的 探讨精细化早期饮食计划在腹腔镜胃癌根治术后患者中的应用效果。 方法 采用便利抽样法，选取2023年7月—12月浙江省杭州市某三级甲等综合医院收治的46例腹腔镜胃癌根治术患者作为试验组，采用精细化早期饮食计划进行管理，2023年1月—6月收治的49例患者作为对照组，以常规方法进行管理。干预时间为术后第1天至出院。比较两组术后首次排气和排便时间、围手术期口渴和饥饿评分、术后住院时间、住院费用、术后并发症及术后30 d再入院发生率的差异。 结果 最终试验组42例和对照组49例完成研究。试验组术后首次排气时间（t=4.922，P<0.001）、术后首次排便时间（Z=-2.440，P=0.015）、围手术期口渴评分（Z=-8.024，P<0.001）、围手术期饥饿评分（Z= -8.192，P<0.001）、术后住院时间（Z=-7.622，P<0.001）、住院费用（Z=-4.522，P<0.001）均低于对照组，差异具有统计学意义；两组术后并发症和术后30 d再入院率比较，差异均无统计学意义（P>0.05）。 结论 实施精细化早期饮食计划有助于腹腔镜胃癌根治术后患者的早期康复，促进肠道功能恢复，缩短住院时间，降低住院费用，改善患者的主观舒适度。

关键词: 胃肿瘤, 胃切除术, 腹腔镜, 早期进食, 护理