| 新型全程循环式营养管理在肿瘤恶病质患者中的应用研究 |
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| 引用本文： | 林友燕,周萍,郑美珍,俞新燕,温晓雪.新型全程循环式营养管理在肿瘤恶病质患者中的应用研究[J].中华全科医学,2021,19(12):2127-2131. |
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| 作者姓名： | 林友燕 周萍 郑美珍 俞新燕 温晓雪 |
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| 作者单位： | 中国科学院大学附属肿瘤医院 浙江省肿瘤医院中西医结合科，浙江 杭州 310002 |
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| 基金项目： | 吴阶平青年科研基金项目320.6750.19003 |
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| 摘 要： | 目的 探讨新型全程循环式营养管理对肿瘤恶病质患者营养状况及生存质量的影响。 方法 选取2019年1月—2021年3月浙江省肿瘤医院收治的符合纳排标准的肿瘤恶病质患者100例，按随机数字法分为对照组50例和治疗组50例。对照组予常规抗肿瘤治疗，治疗组在对照组基础上实施新型全程“院内-居家-返院”循环式营养管理模式。主要管理内容包括成立多学科诊疗模式(multi disciplinary team，MDT)全程管理团队、精细化营养干预、集束化患教模式、建立家庭自我营养管理档案、多手段分层随访质控。分别比较2组患者治疗前和治疗后1、2、4周的生化营养指标、患者主观整体状态评估(patient-generated subjective global assessment, PG-SGA)及日常生活自理能力(barthel index, BI)评分。 结果 2组患者治疗前和治疗后1、2、4周的生化营养指标、PG-SGA评分以及BI评分各项指标均有改善(均P＜0.05)。2组血清白蛋白比较差异无统计学意义(P=0.159)，其他各项指标治疗组均优于对照组，差异有统计学意义(均P＜0.001)。 结论 新型循环式营养管理模式能有效改善患者营养状况，尤其是患者的生活自理能力。因此，不管患者从医院到家庭，还是家庭再到医院，循环式的全程营养管理均应被全程实施，该管理模式值得同行借鉴。
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| 关 键 词： | 新型全程 循环 营养管理 肿瘤 恶病质 |
| 收稿时间： | 2021-05-24 |
Application of a new type of whole-cycle nutrition management in cancer patients with cachexia |
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| Affiliation: | Department of Integrated Chinese and Western Medicine, University of Chinese Academy of Sciences/Zhejiang Provincial Cancer Hospital, Hangzhou, Zhejiang 310022, China |
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| Abstract: | Objective To explore the effect of a new type of whole-cycle nutrition management on the nutritional status and quality of life of cancer patients with cachexia. Methods A total of 100 cancer patients with cachexia were randomly divided into the control group (n=50) and treatment group (n=50). The control group received conventional anti-tumour therapy, whereas the treatment group implemented a new whole-process 'hospital Home Return' circular nutrition management mode. The main contents included the establishment of a multi-disciplinary (MDT) process management team, the intervention of fine nutrition, the establishment of cluster patient education mode, the establishment of family self-nutrition management files and the formation of multi-means hierarchical follow-up. The biochemical nutritional index, patient-generated subjective global assessment (PG-SGA) score and Barthel index (Bi) score were compared before treatment and 1, 2 and 4 weeks after treatment. Results The biochemical nutritional indicators, PG-SGA score and BI score of the two groups before treatment and 1, 2 and 4 weeks after treatment all improved (all P < 0.05). There was no significant difference in serum albumin between the two groups (P=0.159), and other indexes in the treatment group were better than those in the control group (all P < 0.001). Conclusion The new circular nutrition management mode could improve the nutritional status of patients, particularly the self-care ability of patients. Therefore, whether patients move from hospital to home, or home to hospital, the whole cycle of nutrition management should be implemented, and is worthy of reference. |
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