To evaluate the effects of a compound nutritional preparation on postoperative wound healing, immune function, inflammatory response, nutritional status, and intestinal barrier function in patients after cardiovascular surgery, so as to provide a new nutritional intervention strategy for rapid recovery of trauma patients.
From September 2024 to January 2025, 65 eligible patients scheduled for open cardiovascular surgery at the Second Affiliated Hospital of Army Medical University were recruited, and randomly assigned via sealed envelopes to either an experimental group (n=32) or a control group (n=33). From the first day after operation, both groups received isocaloric and isonitrogenous enteral nutritional support for 7 d, and the control group was given a standard formula, while the experimental group took the compound nutritional preparation. Wound healing was assessed with REEDA scale on postoperative days 7 and 14. Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), white blood cell (WBC) count, C-reactive protein (CRP), TNF-α and IL-6 were measured preoperatively and on postoperative days 3 and 7. Immune function was evaluated by T-lymphocyte subsets (CD3+, CD4+, CD8+) and serum immunoglobulins (IgA, IgG, IgM). Nutritional status was assessed via serum albumin (ALB), prealbumin (PA), and total protein (TP). Intestinal barrier function was indicated by serum levels of diamine oxidase (DAO), lipopolysaccharide (LPS) and D-lactate. Body composition analysis was performed preoperatively and on postoperative day 7. Incidence of postoperative infectious complications and length of hospital stay were compared between the 2 groups.
Finally, 60 patients completed the whole study, with 30 participants in each group. No significant differences were found in baseline indicators between the 2 groups. When compared with the control group, the experimental group exhibited significantly lower postoperative REEDA scores, reduced incidence of infectious complications, and shorter length of hospital stay (P<0.05), along with obviously higher skeletal muscle mass index (SMI) and 50 kHz whole-body phase angle (P<0.05). On postoperative day 3, there were no significant differences in above indicator between the 2 groups (P>0.05). On postoperative day 7, notably higher CD3⁺ and CD4⁺ T-cell counts and serum PA levels were observed in the experimental group than the control group (P<0.05). Significant group × time interactions were observed in CD3⁺, CD4⁺, and CD8⁺ T-cell counts and IgA level (P<0.05). Additionally, the experimental group had remarkably lower levels of NLR, CRP, TNF-α, IL-6, DAO, LPS, and D-lactate (P<0.05), with significant group×time interactions for NLR, CRP, IL-6, DAO, and D-lactate (P<0.05). There existed significant group×time interactions in NLR, CRP, IL-6, DAO, and D-lactate.
The compound nutritional preparation can promote wound healing, improve immune function and nutritional status, attenuate the inflammatory response, protect intestinal barrier function, and thereby facilitate postoperative recovery in patients undergoing open cardiovascular surgery.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |