The application of the county medical community HCH model in postoperative nutrition management for patients with advanced gastrointestinal carcinoma

Field: Health Professions (Health Sciences)

Objective: To investigate the application effect of the county medical community Hospital-Community health service organization-Home (HCH) model in nutritional management of patients with advanced gastrointestinal cancer after surgery. Methods: This is a retrospective study. A total of 100 postoperative malnutrition patients with advanced gastrointestinal malignant tumors admitted to Lanxi People’s Hospital from January 2022 to August 2022 were selected as subjects. All patients were divided into an observation group (n=50) or control group (n=50) according to the different methods of intervention. Patients in the observation group underwent care according to our county medical community HCH model, while those in the control group received routine perioperative nutrition management. The nutritional risk screening scores (NRS2002), Patient-Generated Subjective Global Assessment (PG-SGA) scores, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC); a well as levels of serum albumin (ALB), prealbumin (PA), transferrin (TRF), retinol binding protein (RBP), creatinine (Cr) and Free fatty acid (FFA); levels of immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA); and the levels of sodium (Na(+)), potassium (K(+)), calcium (Ca(+)) and lactic acid, and quality of life were recorded and compared between two groups. Results: Compared with those before intervention, NRS2002 scores, PG-SGA score, BMI, TSF and AC after intervention were significantly improved in both groups. Compared with those after intervention in the control group, the NRS2002 score, PG-SGA score, BMI, TSF and AC of the patients in the observation group were significantly improved (all P<0.001). Compared with those before intervention, the levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA in the two groups were significantly higher after intervention. The levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA after intervention in the observation group were significantly higher than those in the control group (all P<0.05). Compared with those before management, the levels of Na(+), K(+) and lactic acid in the two groups were significantly decreased and the level of Ca(+) was significantly increased after intervention. Compared with those after intervention in the control group, the patients in the observation group had significantly lower levels of Na(+), K(+) and lactic acid, and higher levels of Ca(+) (all P<0.05). Compared with those before intervention, the scores of mental status, appetite, sleep quality, daily life and family understanding and cooperation in patients from the two groups after intervention were significantly higher. Compared with those after intervention in the control group, the patients in the observation group had significantly higher scores of life quality (P<0.05). Conclusion: The county medical community HCH model has a good effect in the nutritional management of patients with advanced gastrointestinal cancer surgery. The HCH model can effectively improve the nutritional status, enhance the immune function, and increase the quality of life. Thus it is worthy of clinical application.