Analysis of post-operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post-operative enteral nutrition support nursing combined with early oral feeding

Abstract

The present study aimed to analyze the effects of post-operative enteral nutrition support nursing combined with early oral feeding on post-operative efficacy and pharyngeal fistula (PF) healing in patients with laryngeal cancer (LC). A retrospective analysis of 133 patients with LC, who underwent laryngectomy between May 2014 and September 2016, was conducted. Of these patients, 61 patients (control group) were treated with enteral nutrition support nursing combined with nasogastric feeding, and 72 patients (observation group) were treated with enteral nutrition support nursing combined with early oral feeding. Levels of serum albumin (ALB), pre-albumin (PA), hemoglobin (Hb) and the lymphocyte count (LYM) were compared before and after surgery (7 and 14th post-operative days). The post-operative weight, upper arm muscle circumference (UAMC), triceps skinfold (TSF), post-operative infection, adverse reactions and PF healing were also measured. No differences were observed between the control and observation groups before surgery (all P>0.05). ALB, Hb, PA and LYM were significantly decreased in the control group on the 7 and 14th days post-operatively compared with those in the observation group (all P<0.05). Five patients in the control group presented with PF during treatment, and seven patients in the observation group suffered from PF after surgery. No difference in the average healing time of PF, number of patients with post-operative infection and adverse reactions were observed between the two groups (all P>0.05). The weight and UAMC in the observation group, 14 days post-operatively, were significantly higher than those before surgery in the same patients and in the control group (all P<0.05), whereas no difference in TSF (P>0.05) was observed. No differences in weight, UAMC and TSF were revealed in the control group before surgery and on the 14th day post-operatively (all P>0.05). Thus, post-operative enteral nutrition support nursing combined with early oral feeding resulted in significant improvement in the post-operative efficacy of patients with LC and had no effect on PF healing.

Keywords: LC; PF; enteral nutrition support; oral feeding.

Figure 1.

Change in ALB levels before and after surgery in the two groups. Repeated measures ANOVA followed by Bonferroni's correction was used for analysis. ‘a’ indicates a significant difference compared with 7 days after treatment within the group (P<0.05). ‘b’ indicated a significant difference compared with 14 days after treatment within the group (P<0.05). ‘c’ indicates significant difference between group comparison at 7 days after treatment (P<0.05). ‘d’ indicates a significant difference between group comparison at 14 days (P<0.05). ALB, albumin.

Figure 2.

Change in PA levels before and after surgery in the two groups. Repeated measures ANOVA followed by Bonferroni's correction was used for analysis. ‘a’ indicates a significant difference compared with 7 days after treatment within the group (P<0.05). ‘b’ indicates a significant difference compared with 14 days after treatment within the group (P<0.05). ‘c’ indicates a significant difference between group comparison at 7 days after treatment (P<0.05). ‘d’ indicates a significant difference between group comparisons at 14 days (P<0.05). PA, prealbumin.

Figure 3.

Change in Hb levels before and after surgery in the two groups. Repeated measures ANOVA followed by Bonferroni's correction was used for analysis. ‘a’ indicated that there was a significant difference compared with 7 days after treatment within the group (P<0.05). ‘b’ indicates a significant difference compared with 14 days after treatment within the group (P<0.05). ‘c’ indicates a significant difference between group comparison at 7 days after treatment (P<0.05). ‘d’ indicates a significant difference between group comparison at 14 days (P<0.05). Hb, hemoglobin.

Figure 4.

Change in the lymphocyte count before and after surgery in two groups. Repeated measures ANOVA followed by Bonferroni's correction was used for analysis. ‘a’ indicates a significant difference compared with 7 days after treatment within the group (P<0.05). ‘b’ indicates a significant difference compared with 14 days after treatment within the group (P<0.05). ‘c’ indicates a significant difference between group comparison at 7 days after treatment (P<0.05). ‘d’ indicates a significant difference between group comparison at 14 days (P<0.05).