饮食调整与症状管理对胃切除术后患者营养状态的影响  

Effects of altering intake managing symptoms dietary intervention on nutritional status for patients after gastrectomy

作　　者：王芳 张林颖 刘静 WANG Fang;ZHANG Linying;LIU Jing(Department of Hepartobiliary and Pancreatic Surgery,the First Affiliated Hospital,Air Force Military Medical University,Xi'an 710032,P. R. China)

机构地区：[1]空军军医大学第一附属医院肝胆胰脾外科,西安710032

出　　处：《中国普外基础与临床杂志》2019年第5期551-556,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金面上项目(项目编号:81670563)

摘　　要：目的探讨饮食调整与症状管理(AIMS)对根治性胃切除术后患者整体营养状况及饮食依从性的影响。方法选择2017年4月至2018年7月期间在空军军医大学第一附属医院肝胆胰脾外科实施根治性胃切除术的患者作为研究对象,采用Excel 2007随机函数法将纳入患者分为AIMS组和对照组,AIMS组采用AIMS进行干预,对照组给予常规饮食管理,比较2组患者入院时、出院后第2周及第3个月时的体质量、体质量指数、白蛋白及饮食摄入量情况,采用整体营养主观评估量表(PG-SGA)评估2组患者的整体营养情况,采用饮食相关症状量表和饮食依从性量表对2组患者饮食相关症状和饮食依从性进行评分。结果本研究共纳入符合条件的患者176例,其中AIMS组92例,对照组84例,2组患者的基线资料如性别、年龄、文化程度、职业、疾病类型、手术方式、肿瘤分期及病理分化类型比较差异均无统计学意义(P>0.050)。AIMS组和对照组患者饮食干预前后的体质量、体质量指数和白蛋白比较差异均无统计学意义(P>0.050)。AIMS组和对照组患者出院后2周及3个月时的PG-SGA、饮食相关症状及饮食依从性评分与入院时比较差异均有统计学意义(P<0.050);入院时AIMS组与对照组的PG-SGA、饮食相关症状及饮食依从性评分比较差异均无统计学意义(P>0.050),出院后2周和3个月时AIMS组与对照组比较差异均有统计学意义(P<0.001)。出院后第3个月时,AIMS组患者的饮食摄入量明显高于对照组(P<0.001);AIMS组饮食相关并发症发生率明显低于对照组[5.5%(5/91)比14.6%(12/82),P=0.047]。结论针对根治性胃切除术后患者实施AIMS可以明显改善其整体营养状况及提高饮食依从性。Objective To develop altering intake managing symptoms (AIMS) dietary intervention and evaluate its effects on nutritional status and dietary compliance for patients after gastrectomy. Methods From April 2017 to July 2018, 176 patients underwent the gastrectomy in the Xijing Hospital of Air Force Military Medical University were selected, then were divided into an AIMS group and a control group by the Excel 2007 random function method The AIMS group was intervened by the AIMS dietary intervention, the control group was given the routine diet management. The body mass, body mass index (BMI), albumin, and dietary intake at the admission, on the 2nd week and the 3rd month after the discharge were compared between the two groups. The nutritional status of the two groups was assessed by the PG-SGA scale. The diet-related symptoms and dietary compliance of the two groups were assessed by the dietary related symptoms scale and the dietary compliance scale. Results A total of 176 eligible patients were enrolled in this study, including 92 patients in the AIMS group and 84 patients in the control group. There were no significant differences in the baseline data such as the gender, age, educational level, occupation, disease type, surgical method, tumor TNM stage, and pathological differentiated type between the two groups (P>0.050). There were no significant differences in the body mass,BMI, and albumin between the AIMS group and the control group before and after the dietary intervention (P>0.050). The PG-SGA score, diet-related symptom score, and dietary compliance score had significant differences between on the 2nd week or the 3rd month after the discharge and at the admission in the AIMS group and the control group (P<0.050), which had significant differences on the 2nd week or the 3rd month after the discharge between the AIMS group and the control group (P<0.001). The dietary intake of the AIMS group was significantly higher than that of the control group on the 3rd month after the discharge (P<0.001). The complica

关 键 词：饮食调整与症状管理 根治性胃切除术 整体营养状况 

分 类 号：R735.2[医药卫生—肿瘤]