Objective:To investigate the effect of sarcopenia on physical performance and nutritional status in elderly patients with gastrointestinal tumors.Methods:a total of 120 eligible in-patients were enrolled from gastrointestinal surgery department of a Grade A tertiary hospital in Ningbo city from September 2021 to January 2022. General clinical data were collected, nutritional risk was screened using Nutritional Risk Screening 2002 (NRS 2002), physical performance was assessed by Short Physical Performance Battery (SPPB), skeletal muscle index at the third lumbar vertebra level (L3 SMI) was calculated using abdominal CT scan, and grip strength/muscle strength, gait speed by 6 Meter Timed Walk Test and calf circumference were measured. Subjects were divided into sarcopenia and non-sarcopenia group according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Impacting factors of sarcopenia and the correlation between muscle mass and physical performance in elderly patients with gastrointestinal tumors were analyzed.Results:The overall prevalence rate of sarcopenia in elderly patients with gastrointestinal tumors was 28.3% (34/120) and it was 28.9% (22/76) and 27.3% (12/44) in males and females respectively. There were statistically significant differences in age, tumor stage, nutritional risk, body mass index, calf circumference, L3 SMI, grip strength/muscle strength, gait speed and SPPB score between patients with and without sarcopenia (P<0.05). Muscle strength/grip strength, L3 SMI and gait speed were closely correlated with the occurrence of sarcopenia in elderly patients with gastrointestinal tumors (P<0.05). The L3 SMI was positively correlated with physical performance as assessed with SPPB in both groups.Conclusions:Sarcopenia is a common complication in elderly patients with gastrointestinal tumors with multiple influencing factors. Timely nutritional intervention and exercise intervention should be incorporated into the treatment of elderly gastrointestinal tumor patients with sarcopenia in order to improve nutrition status.

Objective:To investigate the relationship between discharge readiness and nutritional status of patients undergoing gastric cancer surgery in the context of enhanced recovery after surgery (ERAS) , so as to provide individualized guidance for patients after discharge.Methods:Using the convenient sampling method, a total of 120 patients who underwent radical gastrectomy for gastric cancer from June 2020 to June 2021 in Ningbo First Hospital were selected as research objects, and they all received ERAS nursing care. One day before discharge, Nutritional Risk Screening Table and Discharge Readiness Scale were used for questionnaire analysis.Results:The total score of discharge readiness of 120 patients with gastric cancer after surgery was (81.42±6.87) . Among the three dimensions, personal status was (19.65±2.19) , adaptability was (29.67±3.10) and anticipatory support was (32.10±2.61) . 57.5% (69/120) of gastric cancer patients discharged from hospital had nutritional risk. The scores of hospital discharge readiness and the scores of each dimension in the nutritional risk group were lower than those in the non-nutritional risk group, and the differences were statistically significant ( P<0.05) . Multivariate analysis showed that nutritional status was an influencing factor for the total score of hospital discharge readiness in patients with gastric cancer surgery (standardized regression coefficient was 0.321, P<0.05) . Conclusions:Under the background of ERAS, the discharge readiness of patients after gastric cancer surgery is at a moderate level, postoperative patients are generally at nutritional risk and the discharge readiness of patients with nutritional risk is lower than that of patients without nutritional risk. Perioperative nutrition management by nursing staff can improve the discharge readiness of patients undergoing gastric cancer surgery, and continuous nutrition management should be carried out for discharged patients with nutritional risk, in order to promote home rehabilitation of patients with gastric cancer surgery.

Objective? To construct a nursing intervention model based on the theory of planned behavio(r TPB), to prevent deep venous thrombosis (DVT) of lower extremities, and to explore its application in patients with gastrointestinal cancer after operation. Methods? By convenience sampling, a total of 163 patients admitted in the Department of Gastrointestinal Surgery, Ningbo First Hospital, Zhejiang Province who underwent gastrointestinal surgeries from January to December in 2018 were selected as the research objects in this study. The 79 patients admitted from January to June in 2018 were taken as the control group and the conventional perioperative DVT prevention nursing care was given. The other 84 patients admitted from July to December in 2018 were taken as the observation group and the TPB based DVT nursing intervention model was adopted. The two groups were compared in terms of the patient's scores in cognition about DVT, postoperative ankle pump movement, quadriceps femoris movement, first out-of-bed activity within 24 hours and compliance with walking target volume within 3 days after surgery, as well as the number of cases of DVT during hospitalization after surgery. Results? The score of DVT knowledge in the observation group was higher than that in the control group; the compliance of ankle pump movement, quadriceps femoris movement and the proportion of patients getting out of bed for the first time within 24 hours after operation in the observation group were higher than those in the control group; the differences between the two groups were statistically significant (P＜0.05). The rate of achieving 500 m walking goal in the observation group was higher than that in the control group 3 days after operation, but there was no significant difference between the two groups (P＞0.05). There were 7 cases of DVT in control group and 1 case in observation group after operation, and there was statistically significant difference between the two groups (P＜0.05). Conclusions? The DVT nursing intervention model based on TPB is helpful to improve the cognitive level of DVT in patients undergoing gastrointestinal cancer surgery, improve the compliance of lower limb activities and early ambulation, and reduce the incidence of DVT after surgery, establish good healthy behavior for patients undergoing gastrointestinal cancer surgery and effectively prevent DVT.

Objective:To explore the nutritional status and quality of life of gastric cancer patients one month after operation in the context of enhanced recovery, and analyze the correlation between them.Methods:From August 2020 to August 2021, 168 patients discharged from the Gastrointestinal Surgery of Ningbo First Hospital after radical resection of gastric cancer were selected as the study subject by convenience sampling. The Nutritional Risking Screening 2002 (NRS2002) and the Global Leadership Initiative on Malnutrition (GLIM) step 2 (excluding muscle mass measurement index) were used to assess the postoperative nutritional status of patients. The quality of life of patients with gastric cancer after operation was investigated with the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) . Logistic regression analysis was used to explore the influencing factors of nutritional status of postoperative patients with gastric cancer. A total of 168 questionnaires were distributed, and 168 valid questionnaires were recovered, with a valid recovery rate of 100.0%.Results:A total of 104 patients (61.9%) had nutritional risk and 46 patients (27.4%) had malnutrition. There were statistical differences in age, education level, tumor stage, body mass index, physical function, role function, emotional function, cognitive function, general health, fatigue, nausea and vomiting, and loss of appetite among gastric cancer patients with different nutritional status after operation ( P<0.05) . Logistic regression analysis showed that body mass index, physical function, role function, emotional function and fatigue were the influencing factors of the nutritional status of patients one month after operation ( P<0.05) . Conclusions:In the context of enhanced recovery, the nutritional risk and malnutrition rate of gastric cancer patients one month after operation are high, and are closely related to the quality of life. When implementing enhanced recovery after surgery, medical and nursing staff should strengthen and optimize the nutrition management of gastric cancer patients before hospital, during perioperative period and after discharge, improve the nutritional status after operation and the quality of life of patients.