Application of individualized nutrition support for adults with Stanford A aortic dissection. / ä¸ªä½“åŒ–è¥å »æ”¯æŒåœ¨æˆäººStanford A型主动脉夹层中的应用.

OBJECTIVES: Aortic dissection is a serious aortic pathological changes. Although the surgical technique for aortic dissection continues to improve, postoperative mortality and surgical complications are still high. This study aims to explore the effect of individualized nutritional support for the adult Stanford A aortic dissection. METHODS: A total of 60 patients with Stanford A aortic dissection, who were treated in the Department of Cardiovascular Surgery at the First Affiliated Hospital of University of Science and Technology of China from January 2019 to February 2020, were selected. The subjects were divided into a control group (n=29) and an observation group (n=31) by random number table method. The control group received routine nutritional support, and the observation group received individualized nutritional support since the 1st day after surgery. The levels of serum nutritional indexes [albumin (Alb), prealbumin (PAB), hemoglobin (Hb), transferrin (TF)], immune function indexes [immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA)], and inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), procalcitonin (PCT)] on the first day, the 5th day, and the 10th day after surgery were detected by Roche biochemical analyzer, immunoassay analyzer, and microplate reader, respectively. The acute physiology and chronic health evaluation II (APACHEII) was used to evaluate the prognosis on the first day, the 5th day, and the 10th day after surgery, and the incidence of complications was observed in the 2 groups. RESULTS: There were significant differences between the 2 groups in Alb, PAB, Hb, TF, IgG, IgM, IgA, TNF-α, IL-10, and PCT (all P<0.01), and there were also significant differences in the APACHEII, the time factor and the group factor (all P<0.01). On the 5th day and the 10th day after surgery, the levels of Alb, PAB, Hb, TF, IgG, IgM and IgA were higher, and the levels of TNF-α and IL-10 while the scores of PCT and APACHEII were lower in the observation group than those in the control group (all P<0.01). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). CONCLUSIONS: For patients with Stanford A aortic dissection undergoing surgery, the postoperative individualized nutrition support can not only significantly improve nutritional level and immune function, but also effectively reduce levels of postoperative inflammatory factors, which is beneficial to their rapid recovery and has positive clinical significance for reducing postoperative complications and improving prognosis.