Construction and application of home dietary management program for postoperative patients with preventive ileostomy for rectal cancer.

IF 4 2区农林科学 Q2 NUTRITION & DIETETICS

Frontiers in Nutrition Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.3389/fnut.2025.1639987

Jianhua Zhu, Yuanjuan Shen, Juyun Li, Sainan Wang, Wenjuan Shang, Min Sun

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引用次数: 0

Abstract

Background: Rectal cancer is a highly prevalent malignant tumor, and surgery is one of the main treatment methods. Although preventive ileostomy can reduce postoperative complications, it is also prone to cause malnutrition and other problems.

Objective: To construct and validate an early postoperative home dietary management program for patients with preventive ileostomy for rectal cancer, aiming to improve their nutritional status and mitigate clinical ileostomy complications.

Methods: An evidence-based dietary management program was developed, covering dietary transition, nutrient intake, and fluid management. A non-concurrent controlled study was conducted with 66 patients at the Affiliated Hospital of Nanjing University of Chinese Medicine. The intervention group received personalized one-on-one dietary guidance (including pre-discharge assessment of dietary habits, individualized meal planning, and weekly WeChat-based follow-up for food diary reviews) in addition to routine health education, while the control group received routine education only.

Results: At 1 month postoperatively, the intervention group showed significantly better outcomes than the control group in serum albumin (41.00 g/L vs. 38.00 g/L, p = 0.010, r = 0.368), lymphocyte count (1.30 × 10?/L vs. 1.10 × 10?/L, p = 0.009, r = 0.374), and PG-SGA scores (9.85 vs. 10.94, p = 0.037, Cohen's d = 0.525). The intervention group had lower incidences of high-output stoma (HOS; 6.06% vs. 18.18%, OR = 0.29, 95% CI = 0.05-1.56, p = 0.258) and peristomal moisture-associated skin damage (PMASD; 18.18% vs. 24.24%, OR = 0.69, 95% CI = 0.21-2.29, p = 0.547), with positive clinical trends despite no statistical significance.

Conclusion: This home dietary management program can effectively improve short-term postoperative nutritional status in patients, and also plays a positive role in reducing the occurrence of HOS and PMASD.

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直肠癌预防性回肠造口术后患者家庭饮食管理方案的构建与应用

背景：直肠癌是一种高发的恶性肿瘤，手术是其主要的治疗方法之一。预防性回肠造口术虽然可以减少术后并发症，但也容易引起营养不良等问题。目的：构建并验证直肠癌预防性回肠造口术后早期家庭饮食管理方案，以改善患者的营养状况，减少临床回肠造口并发症。方法：建立以证据为基础的饮食管理方案，包括饮食转换、营养摄入和液体管理。对南京中医药大学附属医院66例患者进行非同期对照研究。在常规健康教育的基础上，干预组接受个性化的一对一饮食指导（包括出院前饮食习惯评估、个性化膳食计划、每周微信随访饮食日记回顾），对照组仅接受常规教育。结果：术后1个月，干预组血清白蛋白（41.00 g/L vs. 38.00 g/L, p = 0.010, r = 0.368）、淋巴细胞计数(1.30 × 10？/L vs. 1.10 × 10？/L, p = 0.009, r = 0.374)， PG-SGA评分（9.85比10.94,p = 0.037, Cohen’s d = 0.525）。干预组高输出量造口（HOS; 6.06% vs. 18.18%, OR = 0.29, 95% CI = 0.05 ~ 1.56, p = 0.258）和口周水分相关性皮肤损伤（PMASD; 18.18% vs. 24.24%, OR = 0.69, 95% CI = 0.21 ~ 2.29, p = 0.547）发生率较低，临床趋势积极，但无统计学意义。结论：该家庭饮食管理方案可有效改善患者术后短期营养状况，对减少HOS和PMASD的发生也有积极作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Nutrition Agricultural and Biological Sciences-Food Science

CiteScore

5.20

自引率

8.00%

发文量

2891

审稿时长

12 weeks

期刊介绍： No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health. Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.