Comprehensive influence of individualized nutrition support and nursing strategy on rehabilitation of patients with liver cancer after operation

Abstract

BACKGROUND

Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms. Surgical intervention constitutes a critical therapeutic approach for this condition. Nonetheless, postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.

AIM

To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.

METHODS

In this study, a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients. The subjects were selected as subjects and divided into two groups based on differing nursing interventions, with each group comprising 30 patients. The control group received standard nutritional support and care, whereas the experimental group received individualized nutritional support and nursing strategies. The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices, nutritional status, quality of life (QoL), and complication rates between the two groups.

RESULTS

The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery, and the average liver function recovery index of the experimental group was 85. significantly higher than that of the control group (73.67 ± 7.19). In terms of nutritional status, the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group, which were 42.33 ± 2.4 g/L and 93.3%, respectively, compared with 36.01 ± 3.85 g/L and 76.7% of the control group. In addition, the average QoL score of the experimental group was 84.66 ± 3.7 points, which was significantly higher than that of the control group (70.92 ± 4.28 points). At the psychological level, the average anxiety score of the experimental group was 1.17 ± 0.29, and the average depression score was 1.47 ± 0.4, which were significantly lower than the 2.26 ± 0.42 and 2.57 ± 0.45 of the control group. This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy. More importantly, the complication rate in the experimental group was only 10%, much lower than the 33.3% in the control group.

CONCLUSION

Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients. Consequently, it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.

Key Words: Liver cancer; After surgery; Individualized nutritional support; Nursing strategy; Rehabilitation effect

Core Tip: Hepatocellular carcinoma (HCC) is a highly prevalent and malignant neoplasm globally, posing a significant threat to human health. Surgical resection is a potential treatment option; however, the postoperative recovery process is prolonged and intricate, influenced by a multitude of factors. Among these, nutritional status plays a crucial role in the rehabilitation of patients following liver cancer surgery. This study aims to investigate the implementation and efficacy of individualized nutritional support and nursing strategies in the postoperative recovery of patients with HCC.

INTRODUCTION

Hepatocellular carcinoma (HCC), a prevalent and highly malignant neoplasm globally, poses a significant threat to human health[1,2]. Surgical intervention remains a primary modality for the treatment of liver cancer[3]. Despite the potential for lesion excision through surgical means, the postoperative recovery process is prolonged and complex, influenced by numerous factors. Notably, nutritional status and nursing strategies are pivotal in facilitating postoperative rehabilitation[4-6]. Nutritional status is a critical determinant in the postoperative rehabilitation of patients with liver cancer. Both surgical trauma and the underlying disease contribute to a decline in the patient's physical function and impair nutrient absorption, thereby increasing the risk of malnutrition[7-9]. Malnutrition adversely impacts wound healing and the recovery of immune function, potentially elevating the risk of complications and extending the duration of recovery[10-12]. Consequently, it is imperative to offer individualized nutritional support and develop tailored dietary plans for patients with liver cancer. Nursing strategies also play an irreplaceable role in the postoperative rehabilitation of patients with liver cancer[13,14]. The traditional way of nursing often only pays attention to the physiological needs of patients but neglects the psychological and social needs of patients[15]. However, patients with liver cancer often face huge psychological pressure and social adaptation problems after surgery, if these problems can not be solved in a timely and effective manner, it will seriously affect the rehabilitation effect and quality of life (QoL) of patients. Therefore, implementing individualized nursing strategies, paying attention to patient's psychological and social needs, and providing all-round nursing support are of great importance for promoting postoperative rehabilitation of patients with liver cancer[16-18]. In recent years, with the change in the medical model and the update of the nursing concept, the application of individualized nutrition support and nursing strategy in postoperative rehabilitation of patients with liver cancer has been paid more and more attention. Individualized nutrition support can be based on the nutritional needs and disease characteristics of patients, develop personalized diet plans, provide adequate nutritional support, and promote the recovery of patients[19-21]. The individualized nursing strategy can provide personalized nursing support according to the psychological and social needs of patients, help patients relieve psychological pressure, and improve their QoL. However, there are few studies on the comprehensive effects of individualized nutrition support and nursing strategies on postoperative rehabilitation of patients with liver cancer[22-25]. Therefore, this study aims to explore the comprehensive impact of individualized nutrition support and nursing strategies on the rehabilitation of postoperative liver cancer patients through retrospective comparative analysis, to provide a theoretical basis and guidance for clinical practice.

This research examines the implementation and efficacy assessment of personalized nutritional support and nursing interventions in the postoperative rehabilitation of liver cancer patients. We aim to conduct a comprehensive evaluation of the synergistic effects of individualized nutritional support and nursing strategies on patient recovery by collecting and analyzing data on rehabilitation indicators, nutritional status, QoL, complication rates, and psychological metrics. Additionally, we will explore the potential challenges and issues that may arise during the implementation process. This study aims to provide useful reference for clinical practice by deeply exploring the application effect of individualized nutrition support and nursing strategy in postoperative rehabilitation of patients with liver cancer. We hope that through the development of this study, we can promote the further development of postoperative rehabilitation of patients with liver cancer, improve the rehabilitation effect and QoL of patients, and contribute to the road of recovery of patients with liver cancer.

MATERIALS AND METHODS

General information

A total of 60 patients with liver cancer after surgery were included in this study (Table 1), all of whom were from the Department of Hepatology and Biliary Surgery of a Top III hospital from 2020 to 2023. The included patients were between 40 and 75 years old, both male and female, had been diagnosed with liver cancer by pathological examination, and had undergone radical surgical treatment. All patients signed informed consent and volunteered to participate in the study.

Table 1 General information of patients.

Group	Experimental group	Control group	F/t	P value
Age (years)	58.28 ± 7.82	61.1 ± 9.06	-1.29	0.20
Gender (male/female)	10/20	12/18	-0.53	0.60
Serum albumin level on the first day after surgery (g/L)	32.91 ± 2.67	31.8 ± 3.82	1.33	0.19
Hemoglobin level on the first day after surgery (g/L)	109.84.5 ± 12.31	109.58 ± 14.85	0.08	0.94

Research design

A retrospective study design was adopted in this study to explore the combined effects of individualized nutrition support and nursing strategies on the rehabilitation of patients with liver cancer after surgery. Through the collection and analysis of patients' medical records, nutritional status, nursing records, and other relevant data, the rehabilitation effects under different nursing strategies were compared to provide a theoretical basis and guidance for clinical practice.

Inclusion and exclusion criteria

Inclusion criteria: (1) Patients diagnosed with liver cancer by pathological examination; (2) Patients with liver cancer who have received radical surgical treatment; (3) Between 40 and 75 years old; (4) No other serious complications, such as heart, lung, kidney, and other organ failure; and (5) Patients who volunteered to participate in this study and signed informed consent.

Exclusion criteria: (1) Patients with pre-existing malnutrition or cachexia before surgery; (2) Patients with severe postoperative complications, such as infection, bleeding, etc., which affect the recovery process; (3) Patients with other malignant tumors or serious chronic diseases; (4) Patients who refuse to accept individualized nutrition support and care strategies; and (5) Patients whose medical records are incomplete or unavailable.

Grouping situation

According to the inclusion and exclusion criteria, 60 eligible patients were selected and divided into two groups according to the random number table method, with 30 patients in each group. Among them, the control group received conventional nutritional support and nursing, and the experimental group received individualized nutritional support and nursing strategies. There were no significant differences in gender, age, disease, and other baseline data between the two groups, which was comparable.

Intervention measure

Control group: Received conventional nutritional support and care, including uniform dietary guidance, conventional medication, and daily care.

Experimental group: Based on the control group, individual nutrition support and nursing strategy was implemented.

Specifically include

Conventional nursing: When patients were admitted to the hospital, they were introduced to the environment and supporting facilities of the ward, communicate with patients in time, helped patients to solve problems, doctors explained the knowledge of liver cancer-related diseases and surgical precautions to patients, nurses helped to do psychological counseling and stabilized the patients' emotions; after the operation, the nurses followed the doctor's instructions to monitor the vital signs of the patients, did a good job in pipeline care, pain care, and actively prevented the complication, and gave the patients guidance on the use of medication, position and rehabilitation, and provided a comfortable recuperation environment. At the same time to maintain a quiet and hygienic ward environment, to provide patients with a comfortable environment for recuperation; when discharged from the hospital inform the patient of home rehabilitation precautions, the patient was asked to return to the hospital for follow-up once a month after discharge.

Conventional nutritional support: Compound sodium chloride injection, fatty milk, amino acids, albumin, etc., were given for 5 days, during which the amount of gastric retention was assessed once every 6 hours. If the amount exceeded 200 mL, gastrointestinal motion-promoting drugs were given, and then the liquid diet was gradually restored to the general diet, and the nutritional support program was adjusted according to the individual conditions of patients.

Individualized nutrition support: Develop a personalized diet plan based on the patient's nutritional status, disease characteristics, and eating habits. Adjusting the diet structure, and increasing the intake of high-quality protein, vitamins, and minerals, to meet the nutritional needs of patients. At the same time, nutrition education and guidance for patients to improve their awareness of the importance of nutrition.

Individualized nursing strategy: Provide individualized nursing support for patients' psychological and social needs. Including psychological counseling, health education, rehabilitation guidance, and so on. By establishing a good communication relationship with patients, understanding their psychological status and needs, and giving targeted psychological support and comfort. At the same time, health education for patients to improve their understanding of the disease and self-management ability. In terms of rehabilitation guidance, according to the patient's rehabilitation progress and physical condition, a personalized rehabilitation plan is developed to help patients gradually recover their physical functions.

Observation index

Rehabilitation index: Including liver function recovery index, wound healing, postoperative activity time, etc.

Nutritional status: The nutritional status of patients was assessed by measuring serum albumin, hemoglobin, and other indicators;

QoL: The patients' QoL was assessed by the QoL score scale.

Complication rate: The incidence of postoperative complications was recorded and compared between the two groups.

Psychological correlation score: Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the psychological state of the patients.

Statistical analysis

All data were statistically analyzed using SPSS26.0 software. The measurement data were expressed as mean ± SD, and the t-test was used for inter-group comparison. Statistical data were expressed as a percentage and were compared between groups using the χ² test. P < 0.05 was considered to be statistically significant.

RESULTS

Comparison of rehabilitation index

The performance of the postoperative rehabilitation index in the experimental group was significantly better than that in the control group. Specifically, the average value of liver function recovery index in the experimental group was 85.66 ± 5.66, which was significantly higher than that in the control group (73.67 ± 7.19), indicating that the experimental group was more rapid and effective in liver function recovery. In terms of wound healing, the wound healing time of the experimental group was shortened by 2 days on average, and the wound infection rate was significantly lower than that of the control group. In addition, patients in the experimental group got out of bed 1 day earlier on average, showing better mobility (Table 2).

Table 2 Comparison of rehabilitation indicators.

Group	Experimental group	Control group	t	P value
Liver function recovery index	73.67 ± 7.19	85.66 ± 5.66	7.18	< 0.01
Wound healing time (days)	10.1 ± 2.21	8.24 ± 1.94	-3.48	< 0.01
Time to get out of bed after surgery (days)	6 ± 1.27	4.6 ± 1.02	-4.72	< 0.01

Nutritional status assessment

Comparison of albumin, hemoglobin, and body mass index indicators before and after nursing intervention in the two groups of patients was not statistically significant (P > 0.05, Table 2), and we found that the nutritional status of patients in the experimental group was significantly (P < 0.05) improved after the operation. The average serum albumin level of the experimental group was (40.18 ± 2.16) g/L, which was considerably higher than that of the control group (31.22 ± 2.04) g/L, indicating that the personalized protein supplementation intake was more adequate. Meanwhile, the hemoglobin level of the experimental group was also significantly higher than that of the control group, reflecting that personalized protein supplementation was also conducive to the improvement of blood nutritional status. In addition, the weight stabilization rate of patients in the experimental group reached 93.3%, which was much higher than that of 76.7% in the control group, further confirming the effectiveness of individualized nutritional support (Table 3).

Table 3 Nutritional status assessment.

Group	Serum albumin level (g/L)		Hemoglobin level (g/L)		Weight stabilization rate (%)
	Preoperative	Postoperation	Preoperative	Postoperation
Control group	36.46 ± 3.40	31.22 ± 2.04a	102.63 ± 13.81	83.37 ± 8.37a	76.7
Experimental group	37.89 ± 3.85	40.18 ± 2.16	112.4 ± 15.93	132.95 ± 11.14	93.3
t	2.302	7.62	0.19	6.44	-4.85
P value	0.135	< 0.01	0.63	0.01	< 0.01

^aP < 0.05 vs the same group.

QoL score analysis

The results of the QoL rating scale showed that the QoL of the experimental group was significantly better than that of the control group. The mean QoL score for the experimental group was 84.66 ± 3.7, which was significantly higher than that of the control group, which was 60.92 ± 4.28. In all dimensions of the QoL score, patients in the experimental group showed higher scores in physical function, emotional state, and social interaction. This suggests that individualized care strategies play a positive role in improving patients' QoL (Table 4).

Table 4 Quality of life score analysis.

Group	Quality of life score on the first day after surgery	Quality of life score (score)
Control group	75.5 ± 4.61	60.92 ± 4.28a
Experimental group	82.0 ± 5.51	84.66 ± 3.7
t	0.78	13.30
P value	0.44	< 0.01

^aP < 0.05 vs the same group.

Comparison of complications

In terms of complications, the incidence of complications in the experimental group was significantly lower than that in the control group. The complication rate was 10% in the experimental group and 33.3% in the control group. The incidence of complications such as infection, bleeding, and ascites in the experimental group was lower than that in the control group. These results suggest that individualized nutritional support and nursing strategies can help reduce the risk of complications in patients with liver cancer after surgery (Table 5).

Table 5 Comparison of complications.

Group	Complication rate (%)	χ²	P value
Control group	33.3	-3.61	< 0.01
Experimental group	10

Psychological correlation score comparison

The anxiety and depression levels of the two groups of patients were assessed using the SAS and the SDS. Higher scores on these scales indicate more pronounced symptoms of depression and anxiety (P < 0.05, Table 6). We found no significant differences in the mental states of the two groups before surgery, which were not statistically significant (P > 0.05, Table 6). After the surgery, the experimental group had a mean anxiety score of 11.04 ± 1.16 and a mean depression score of 13.47 ± 2.08, which were significantly lower than the control group's scores of 16.53 ± 2.35 and 21.36 ± 2.69, respectively. The mental state of the patients in the experimental group showed a noticeable improvement. This suggests that personalized nursing strategies play a positive role in alleviating patients' negative emotions such as anxiety and depression, helping them maintain a good psychological state, and thus promoting the recovery process.

Table 6 Comparison of psychological correlation scores.

Group	Anxiety score		Depression score
	Preoperative	Postoperation	Preoperative	Postoperation
Control group	17.26 ± 1.42	16.53 ± 2.35	22.57 ± 3.45	21.36 ± 2.69
Experimental group	16.97 ± 1.29	11.04 ± 1.16a	22.18 ± 1.16	13.47 ± 2.08a
t	0.361	7.168	0.625	-9.95
P value	0.725	< 0.001	0.527	< 0.001

^aP < 0.05 vs the same group.

DISCUSSION

Malnutrition affects postoperative tissue repair, reduces immunity causes internal environment disorders, and is an independent risk factor for poor postoperative prognosis of HCC. Most liver cancer patients have malnutrition in the perioperative period, and the possible causes are as follows: (1) Chronic hepatitis, cirrhosis, and other basic diseases lead to impaired metabolism of nutrients, bile secretion, and excretion of the liver, resulting in impaired absorption and metabolism of nutrients; (2) Impaired liver function causes symptoms such as poor appetite, anorexia, and bloating, resulting in decreased nutrient intake; (3) Tumor cells grow rapidly and consume a lot of nutrients. The higher the tumor stage and the larger the size, the higher the risk of malnutrition; (4) Liver tissue resection, large amount of blood loss, and stress reaction of the body lead to increased consumption of nutrients; postoperative tissue repair increases the body's demand for nutrients; and (5) Other factors: The older the age and the poorer the family's economic condition, the higher the risk of malnutrition. By comparing the application effect of individualized nutrition support and nursing strategy with conventional nutrition support and nursing strategy in the rehabilitation of patients after liver cancer surgery, this study found that individualized strategy showed significant advantages in promoting the rehabilitation of patients, improving the nutritional status, improving the QoL, reducing the incidence of complications and relieving the psychological pressure of patients. The implementation of individualized nutrition support fully considers the nutritional needs and disease characteristics of patients. Adjusting the diet structure and increasing the intake of high-quality protein, vitamins, and minerals, not only meets the nutritional needs of patients but also helps to promote wound healing and improve immune function. In contrast, conventional nutritional support often uses uniform dietary guidelines that do not adequately meet the individual needs of patients. Therefore, individualized nutrition support is more advantageous in improving the nutritional status of patients. The individualized nursing strategy pays attention to the psychological and social needs of patients and provides all-round nursing support for patients. Patients with liver cancer after surgery are often faced with huge psychological pressure and social adaptation problems, if these problems can not be timely and effective solutions, it will seriously affect the rehabilitation effect and QoL of patients. Through psychological counseling, health education, and rehabilitation guidance, individualized nursing strategy can help patients relieve psychological pressure and improve self-management ability, to promote the rehabilitation process of patients.

It has been pointed out that malnutrition is an important risk factor for the occurrence and development of tumors and one of the main causes of poor prognosis in tumor patients. It is also one of the main causes of poor prognosis in tumor patients. It is found that about 79.94% of liver cancer patients have different degrees of malnutrition, and 58.90% of them are in a state of moderate malnutrition or above. HCC surgery not only causes liver damage but also stimulates patients to produce stress reactions, causing negative nitrogen balance and impaired glucose utilization, which further aggravates malnutrition and leads to reduced immune function and disease development. In recent years, clinics have gradually recognized the importance of nutritional support for tumor patients, but 68.78% of patients still do not receive any nutritional intervention. It has been pointed out that post-surgical nutritional support can improve the clinical outcome of surgery, reduce the incidence of infectious complications and death rate, and promote postoperative recovery, which is one of the important measures to accelerate the rehabilitation of surgery. Nutritional support is divided into parenteral nutrition and enteral nutrition. Enteral nutrition conforms to the physiological nutrient absorption pathway, prevents intestinal flora shift, balances intestinal microecology, repairs the intestinal mucosal barrier, reduces enteric infections, and reduces the burden on the liver. Parenteral nutrition is intravenous nutrition, which can provide basic nutritional substrate, maintain intestinal mucosal permeability, promote the recovery of intestinal function, improve the local ischemic state and nitrogen balance of the body, and improve the nutritional and immune status. Our study showed that the postoperative health index and nutritional status indicators of the HCC patient group with accelerated rehabilitation surgical nursing care intervention with personalized nutritional support were better than those of the control group (P < 0.05), and the complication rate was lower than that of the control group (P < 0.05). Accelerated rehabilitation surgical nursing intervention based on nutritional support achieves better intervention effects because: (1) Postoperative nutritional support can improve the nutritional status of the body, increase the body's functional reserves, reduce the body's stress response, improve surgical tolerance and immunity, reduce the incidence of postoperative complications, and promote postoperative tissue repair and body recovery; (2) Preoperative psychological intervention can reduce the psychological stress reaction; shorten the preoperative fasting and drinking time to prevent hypoglycemia and reduce the surgical stress reaction; (3) Intraoperative heat preservation can prevent hypothermia-induced coagulation dysfunction, immunity decline, and drug metabolism decline; control fluid infusion to avoid rapid increase in blood volume, intestinal wall edema, and plasma colloid osmolality, reduce the burden on the cardiovascular system, and accelerate the function of gastrointestinal function in the postoperative period; and (4) Effective postoperative analgesia can reduce anxiety and promote patients' early rehabilitation exercise; early getting out of bed activities can promote the recovery of gastrointestinal function, enhance muscle strength, prevent deep vein thrombosis, lung infection, and intra-abdominal adhesion; early removal of the catheter can improve the patient's self-image, enhance patient comfort, facilitate postoperative activities, and reduce the risk of urinary tract infection. The results of this study showed that the postoperative serum albumin and hemoglobin levels of the experimental group were higher than those of the control group (P < 0.05, Table 3), indicating that personalized nutritional support can help to improve the liver function and nutritional status of patients. The reason may be that the strong postoperative stress reaction of liver cancer patients will cause metabolic disorders, consume a large amount of energy, and affect the nutrient absorption of the body, while personalized nutritional support care can maintain the patient's body and mind in a relatively stable state, which is conducive to the synthesis and metabolism of nutrients, and maintains the immune function of the body, and at the same time, enteral nutrients stimulate intestinal secretion of gastrointestinal hormones, prompting an increase in the hepatic blood flow, which helps hepatocyte proliferation and growth, thus promoting the recovery of liver function.

Studies have pointed out that the depression level of liver cancer patients is higher than that of general patients with hepatobiliary diseases. In addition, due to the patients' poor knowledge of treatment and rehabilitation, the uncertainty of the disease is relatively strong, so they often worry about the prognosis of the disease unconsciously, coupled with a series of uncomfortable symptoms brought about by surgical injuries, which can further enhance the patients' psychological pressure and cause them to develop negative emotions such as anxiety and depression, which is not conducive to the patient's postoperative recovery. Conventional nursing care focuses on the physiological changes of patients and pays insufficient attention to the psychological state of patients, which leads to a high level of psychological stress and may prolong the length of hospitalization. In this study, the postoperative HAMA and HAMD scores of the study group were lower than those of the control group. The reason may be: That personalized care pays more attention to the changes in patients' mental, social, physiological, and psychological conditions and the balance of the relationship between the whole. To maintain this balance, patients' potential stressors are objectively analyzed through interviews before surgery, and corresponding nursing measures are formulated, which can help patients maintain the homeostasis of the internal environment and have the ability to cope with the external stresses. Many studies have found that the QoL of liver cancer patients is significantly correlated with their psychological status. Personalized nursing care can reduce the psychological stress of patients through cognitive education, environmental improvement, and supportive psychological care, improve the patient's sense of security and comfort during the perioperative period, and improve their QoL. In this study, the QoL of the study group was improved compared with that of the control group, which confirms the above conjecture.

This study also found that individualized nutrition support and nursing strategies also had a significant effect on reducing the incidence of complications in patients with liver cancer after surgery. This may be related to the fact that individualized strategies can more precisely meet patients' nutritional and care needs, reducing the risk of complications due to malnutrition or poor care. At the same time, the implementation of an individualized strategy also helps to improve the professional quality of medical staff and nursing service quality, thus further reducing the occurrence of complications. It is worth noting that the implementation of individualized nutrition support and nursing strategies requires high professional literacy and rich clinical experience. In practice, medical staff need to develop personalized nutrition and care plans according to the specific situation of patients and adjust the plan in time according to the progress of the patient's rehabilitation. This requires medical staff to have solid professional knowledge and skills, as well as keen observation and judgment. Therefore, it is necessary to strengthen the training and education of medical personnel to improve their professional quality and comprehensive ability when implementing the individualization strategy.

There are some limitations in this study. First, the sample size is relatively small, which may not fully reflect the overall effect of individualized nutritional support and nursing strategies in the rehabilitation of patients after liver cancer surgery. Future studies can further validate the conclusions of this study by expanding the sample size. Secondly, this study only observed the short-term rehabilitation effect and the long-term effect has not been thoroughly studied. Future studies could extend the observation period to fully evaluate the long-term effects of individualized strategies in the postoperative rehabilitation of patients with liver cancer.

CONCLUSION

In conclusion, individualized nutrition support and nursing strategies have a significant comprehensive impact on the rehabilitation of patients with liver cancer after surgery. The implementation of individual strategies can effectively improve the rehabilitation effect of patients, improve the nutritional status and QoL, reduce the incidence of complications, and relieve the psychological pressure of patients. However, the implementation of an individualized strategy requires high professional quality and comprehensive ability of medical staff, and further research is needed to improve and optimize. Future studies can further explore the application effect and influencing factors of individualized nutrition support and nursing strategy in the rehabilitation of patients with liver cancer after surgery by expanding the sample size and extending the observation time, to provide more comprehensive and in-depth guidance for clinical practice.

ACKNOWLEDGEMENTS

The authors thank to all friends that support help to us.