ObjectiveTo research on the influence of cluster management on the nutritional intervention for nasopharynx cancer patients undergoing intensity modulated radiation therapy (IMRT), in order to discuss effective and feasible nutrition management method. MethodEighty-three nasopharynx cancer patients undergoing IMRT between June 2013 and December 2014 were selected as the study subjects. They were divided into two groups randomly. Regular health education and nutritional guidance were carried out for the 41 patients in the control group, while nutritional risk screening (NRS)-2002 nutrition screening, nutrition assessment and nutritional intervention were carried out for the 42 patients in the intervention group. Nutrition risk, nutritional status and side-reaction were recorded and evaluated for both groups of patients. ResultsAfter treatment, NRS-2002 score of the intervention group was lower than the control group (P<0.05). Body weight, constitutional index, skinfold thickness of triceps brachii muscle, mid-arm circumference and mid-arm muscle circumference of the intervention group were better than the control group (P<0.05). Total serum protein, serum albumin, serum transferrin were better and the rate of levelⅢ-Ⅳ radiation-induced oral mucositis was lower in the intervention group than that in the control group (P<0.05). ConclusionsThe application of cluster management model in nutritional intervention is a way to promote patients' rehabilitation, which can effectively improve the whole body situation of nasopharynx cancer patients, and reduce malnutrition rate and side-reaction.
Objective To investigate the comprehensive efficacy and cost-effectiveness of early nutritional intervention combined with acupoint electrical stimulation under the enhanced recovery after surgery (ERAS) concept in elderly patients undergoing total hip arthroplasty (THA), and to verify the robustness of the results through Monte Carlo validation. Methods Elderly patients who underwent THA in the Ziyang Central Hospital between January 2022 and December 2024 were retrospectively selected. Patients who did not implement the ERAS protocol between January and December 2022 were included in the control group, while patients who implemented the ERAS protocol between January 2023 and December 2024 were included in the intervention group. Total hospitalization costs, postoperative complication rates, patient satisfaction, and clinical indicators were collected to construct a comprehensive efficacy score. Monte Carlo validation was used to analyze the incremental cost-effectiveness ratio and parameter uncertainty. Results A total of 140 patients were enrolled, with 70 in each group. There were no statistically significant differences in gender, age, and preoperative indicators between the two groups (P>0.05). The Richmond Agitation-Sedation Scale scores [(?0.03±0.87) vs. (0.53±0.85) points; P<0.05] and the incidence of agitation [5.7% (4/70) vs. 34.3% (24/70); P<0.05] were lower in the intervention group compared to the control group. The total incidence of adverse reactions in the postoperative intervention group [5.7% (4/70) vs. 18.6% (13/70); P<0.05] was lower than that in the control group. The comprehensive efficacy score, hospitalization costs, and cost-effectiveness ratio were all superior in the intervention group compared to the control group (P<0.05). Monte Carlo validation results further confirmed the advantages of early nutrition combined with acupoint electrical stimulation in improving cost-effectiveness. Conclusions ERAS-based early nutritional intervention combined with acupoint electrical stimulation can significantly enhance the comprehensive efficacy and reduce medical costs in elderly THA patients. Monte Carlo validation verifies the robustness of its cost-effectiveness, providing health economic evidence for clinical decision-making.