How to prevent postoperative hypoproteinemia in elderly patients undergoing lumbar surgery?

As my country rapidly enters an aging society, the incidence of lumbar degenerative diseases in the elderly population over 60 years old can be as high as 30%, mainly lumbar spinal stenosis, lumbar disc herniation, etc. At present, lumbar surgery is still one of the main ways to treat such diseases. The surgery is traumatic and the amount of bleeding is large. In addition, elderly patients may have multiple medical diseases and poor nutritional status, and the incidence of postoperative complications is relatively high. Among them, hypoproteinemia is very important and often overlooked. Studies have shown that hypoproteinemia is the main factor affecting the increased risk of postoperative infection, poor wound healing, prolonged hospitalization, and increased mortality. So how much benefit does protein have for the human body, and how to prevent the occurrence of hypoproteinemia after surgery? Let me talk to you about some little knowledge about protein.

1. What role does protein play in the human body?

Protein is one of the important nutrients for the formation and repair of human tissues, accounting for 16.3% of human body weight. The growth and development of the human body, the renewal of aging tissues, and the repair of damaged tissues all require protein as the most important "building material" of the body. In particular, it has five prominent functions: participating in the construction of the immune system, maintaining normal metabolism, providing special amino acids, providing energy for human activities, and being a transporter of important substances.

2. What harm does protein deficiency do to the human body?

The lack of protein in the human body is medically known as hypoproteinemia, which refers to a state of reduced serum albumin. When serum albumin is <35g/L, it means that the body has protein-energy malnutrition, which can have an adverse effect on the recovery of patients after surgery. Many studies have shown that hypoproteinemia can significantly increase the risk of complications after lumbar fusion surgery in adults, including poor wound healing, postoperative infection, and prolonged hospitalization.

3. How do perioperative patients supplement protein?

The amount of protein required by healthy adults is 65g/d for men and 55g/d for women. Perioperative patients need a large amount of high-quality protein, which can be supplied at 1.5-2.0g/kg.d. Usually these patients need 90-140g of protein per day. The main sources of high-quality protein are: milk, probiotic yogurt, eggs, lean beef, donkey meat, lean pork, skinless chicken and duck meat, fish and shrimp, tofu, tofu brain, tofu shreds, etc.

4. What should I do if I don’t get enough protein from food?

Protein powder is a good choice, but the quality of protein powder varies greatly. From the perspective of the ingredients of protein powder, there are mainly whey protein, soy protein isolate, and casein. Many current studies have confirmed that whey protein powder is the best quality and can better provide high-quality protein for the human body, promote wound healing, maintain muscle, improve the body's immunity, and prevent and treat the four highs.

5. Which groups of people are not suitable for a high-protein diet?

A high-protein diet is generally not recommended for people who are allergic to protein or suffer from pancreatitis, chronic kidney disease, etc. The reasons are as follows:

①Protein allergy: Some people will have an allergic reaction to protein, which can cause skin itching. In this case, it is not recommended to eat high-protein foods.

② Pancreatitis: During the course of the disease, it is forbidden to eat any food, and high-protein diet is usually also prohibited to avoid irritation to pancreatic function.

③Chronic kidney disease: It may affect the compensatory ability of the kidneys. If you consume too much protein food, it is likely to increase the burden on the kidneys.

High-protein diet is prohibited for people with uremia, renal failure, high creatinine, etc.

Of course, in addition to eating high-protein foods, carbohydrates, dietary fiber, vitamins, etc. are also components of reasonable nutrition.

In general, nutritional support after spinal surgery is crucial for the patient's rehabilitation and treatment. A reasonable diet can help patients improve treatment effects, relieve adverse symptoms, and improve their quality of life to a certain extent. The above is only a personal opinion. Specific nutritional care should be adjusted according to the individual differences and treatment responses of the patient to obtain the best nutritional effect. (An Yonghui, Spine Department 4, The Third Hospital of Hebei Medical University)