胃肠道肿瘤患者全程化营养管理的效果分析
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摘要
目的探究胃肠道肿瘤患者全程化营养管理的效果。方法选择2017年7月到2018年7月期间采用NRS2002评分具有营养风险的拟行胃肠道肿瘤根治性手术的患者80例作为研究对象,给予患者围手术期足量的营养支持,患者出院时进行全面的营养指导,观察患者入院时、出院时、出院一个月复查时小腿围、体重、BMI、血红蛋白、血清总白蛋白等变化情况。结果患者出院时体重由入院时(53.96±8.19)kg下降至(50.13±7.97)kg,差异有统计学意义(P<0.05);患者出院时小腿围、BMI与入院时比较差异有统计学意义(P<0.001);患者出院时总蛋白、前白蛋白、白蛋白、血红蛋白与入院时比较差异均有统计学意义(P<0.001),患者复查时总蛋白、前白蛋白、白蛋白与出院时比较差异有统计学意义(P<0.001)。结论虽然对胃肠道肿瘤患者围手术期、出院后进行了全程化的营养管理,但是患者营养状况仍然损害严重,因此对胃肠道肿瘤患者的营养管理是一个持续的过程。
Objective To explore the effect of whole-course nutritional management in patients with gastrointestinal cancer. Methods From July 2017 to July 2018,80 patients with gastrointestinal cancer undergoing radical surgery were collected, and nutritional risk was assessed by NRS2002,patients were given sufficient nutritional support during perioperative period and given comprehensive nutritional guidance when they discharged from hospital. Evaluate calf size, BW, BMI, Hb, TP, etc. at the time of admission, discharge, and one month after discharge. Results The BW of patients decreased from 53.96±8.19 kg to 50.13±7.97 kg at discharge when compared that at admission(P<0.05). The CS and BMI between the admission and the discharge was statistically significant difference(P<0.001); There were statistically significant differences in TP, PA, ALB, and Hb at discharge when compared those at the time of admission(P<0.001). There were differences in TP, PA, ALB at discharge when compared those at the time of post-discharge(P<0.001). Conclusion Although the patients with gastrointestinal cancer have undergone whole-course nutrition management during the perioperative period and post-discharge, However, the nutritional status of patients is still seriously damaged, so the management of nutrition in patients with gastrointestinal cancer is an ongoing process.
Objective To explore the effect of whole-course nutritional management in patients with gastrointestinal cancer. Methods From July 2017 to July 2018,80 patients with gastrointestinal cancer undergoing radical surgery were collected, and nutritional risk was assessed by NRS2002,patients were given sufficient nutritional support during perioperative period and given comprehensive nutritional guidance when they discharged from hospital. Evaluate calf size, BW, BMI, Hb, TP, etc. at the time of admission, discharge, and one month after discharge. Results The BW of patients decreased from 53.96±8.19 kg to 50.13±7.97 kg at discharge when compared that at admission(P<0.05). The CS and BMI between the admission and the discharge was statistically significant difference(P<0.001); There were statistically significant differences in TP, PA, ALB, and Hb at discharge when compared those at the time of admission(P<0.001). There were differences in TP, PA, ALB at discharge when compared those at the time of post-discharge(P<0.001). Conclusion Although the patients with gastrointestinal cancer have undergone whole-course nutrition management during the perioperative period and post-discharge, However, the nutritional status of patients is still seriously damaged, so the management of nutrition in patients with gastrointestinal cancer is an ongoing process.
引文
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[10]沈海滨,刘小金,刘锐,等.围手术期口服肠内营养制剂对结直肠癌患者术后营养免疫状况及术后并发症的影响[J].浙江医学,2018,08:843-847.
[2]广东省医师协会加速康复外科医师分会.岭南结直肠外科手术麻醉的加速康复外科临床操作规范专家共识(2016版)[J].消化肿瘤杂志:电子版,2016,8(4):209-219.
[3]马纯雪,徐晓琼,黄仁微.胃肠道肿瘤患者营养风险筛查特点及其对术后并发症的影响[J].中华全科医学,2014,12(12):1902-1904.
[4]胃肠道肿瘤术后辅助化疗病人营养不良现状调查与分析[J].肠外与肠内营养,2017,24(6):336-340.
[5]张晓伟,李薇,陈公琰,等.中国医务人员肿瘤营养知识-态度-行为调查分析[J].肿瘤代谢与营养电子杂志,2016,3(2):108-113.
[6]覃日清,张馨,邓丽彩.胃肠道肿瘤病人术后饮食状况调查分析[J].护理研究,2016,30(16):2001-2003.
[7]Chen W,Zhang Z,Xiong M M,et al.Early Enteral Nutrition after Total Gastrectomy for Gastric Cancer[J].Asia Pacific Journal of Clinical Nutrition,2014,23(4):607-611.
[8]方玉,辛晓伟,王艳莉,等.肿瘤患者家庭肠内营养治疗的规范化管理[J].肿瘤代谢与营养电子杂志,2017,4(1):97-103.
[9]中华医学会肠外肠内营养学分会.肿瘤患者营养支持指南[J].中华外科杂志,2017,55(11).
[10]沈海滨,刘小金,刘锐,等.围手术期口服肠内营养制剂对结直肠癌患者术后营养免疫状况及术后并发症的影响[J].浙江医学,2018,08:843-847.