围手术期消化道肿瘤患者营养风险与营养支持情况研究

目的对围手术期消化道肿瘤患者营养风险情况、营养支持情况进行调查探究,了解围手术期消化道肿瘤患者营养管理现状,为营养干预质量提升提供指导。 方法选取2021年4月至2022年4月解放军总医院第一医学中心消化内科医学部收治手术治疗的消化道肿瘤患者为研究对象,通过营养风险筛查表(NRS2002)与临床资料收集分析,了解其营养风险与营养支持情况。 结果本次纳入研究的患者684例,年龄平均(58.65±12.25)岁,体重指数正常者占60.09%,体重异常者占39.91%。从体重指数来看,营养不良风险位于前3位的临床诊断为食管癌(13.46%)、胃癌(17.09%)、肠癌(18.06%)。NRS2002平均分为(4.26±1.84)分,35.67%的患者NRS2002评分≥3分,以肠癌、胃癌、食管癌为主。266例(38.89%)患者在围手术期接受营养支持,其中肠外营养占79.70%。NRS2002评分≥3患者中71.72%接受营养支持,NRS2002评分<3患者中20.68%接受营养支持。食管癌(32.05%)、胃癌(56.96%)、肠癌(56.25%)、肝癌(29.59%)患者接受营养支持的比例较高。营养支持后患者营养指标水平高于营养支持前(P<0.05)。 结论围手术期消化道肿瘤患者营养不良风险较高,营养支持对改善患者健康状况存在积极影响。目前虽然有部分消化道癌患者在围手术期接受了营养支持,但从整体来看营养支持仍有待改进。

Nutritional risk and nutritional support in patients with gastrointestinal neoplasms during perioperative period

ObjectiveTo explore the current status of nutritional risk, nutritional support, and nutritional management in patients with gastrointestinal tumors in the perioperative period, to provide guidance for improving the quality of nutritional intervention. MethodsPatients with gastrointestinal tumors admitted to the Department of Gastroenterology, the First Medical Center of PLA General Hospital from April 2021 to April 2022 were selected as the research objects. The nutritional risk screening form (NRS2002) was used and clinical information were collected to analyzed their nutritional risk and nutritional support. ResultsA total of 684 subjects were included in this study, with an average age of (58.65±12.25) years old, 60.09% of them had normal body mass index, and 39.91% had abnormal body weight. In terms of body mass index, the top three clinical diagnoses of malnutrition risk were esophageal cancer (13.46%), gastric cancer (17.09%), and bowel cancer (18.06%). The average score of NRS2002 was (4.26±1.84), and 35.67% of the patients had NRS2002 score ≥3, mainly colorectal cancer, gastric cancer and esophageal cancer. A total of 266 patients (38.89%) received perioperative nutritional support, and 79.70% of them received parenteral nutrition. 71.72% of patients with NRS2002 score ≥3 received nutritional support, and 20.68% of patients with NRS2002 score < 3 received nutritional support. Patients with esophageal cancer (32.05%), gastric cancer (56.96%), bowel cancer (56.25%) and liver cancer (29.59%) were more likely to receive nutritional support. The level of nutritional indexes after nutritional support was higher than that before nutritional support (P< 0.05). ConclusionsThe malnourished risk of patients with gastrointestinal cancer in perioperative period is high. Nutritional support has a positive effect on improving the health status of patients. At present, although some patients with gastrointestinal cancer receive nutritional support during perioperative period, the overall nutritional support still needs to be improved.