安徽地区住院消化系统恶性肿瘤患者营养现状及营养药物使用的多中心横断面研究  

A multicenter cross-sectional survey on nutritional status andusing nutritional drugs for hospitalized patients with malignant digestive system tumors in Anhui area

作　　者：刘红[1] 黄赵刚[1] 王小华[1] 夏泉[1] LIU Hong;HUANG Zhao-gang;WANG Xiao-hua;XIA Quan(Department of Pharmacy,First Affiliated Hospital,Anhui Medical University,Anhui Hefei 230061,China)

机构地区：[1]安徽医科大学第一附属医院药学部,安徽合肥230061

出　　处：《中国医院药学杂志》2021年第10期1044-1048,共5页Chinese Journal of Hospital Pharmacy

基　　金：安徽省十三五临床重点专科建设项目(临床药学)基金(编号:卫科教秘[2017]529号)。

摘　　要：目的:借鉴欧洲肠外肠内营养学会营养日(NutritionDay)调查问卷方法,评估安徽地区部分三甲医院住院消化系统恶性肿瘤患者营养状况及营养药物使用现状。方法:采用横断面调查方法,设计修订NutritionDay调查问卷,收集2018年12月5日当天安徽地区11家综合性三甲医院诊断为消化系统恶性肿瘤的成年住院患者的基本信息、营养风险、营养状况、营养干预、营养药物使用、营养治疗工作开展情况等相关内容。结果:534例患者完成调查,排除不合格问卷38份,最终496份问卷纳入研究。70.2%(348/496)的患者存在营养风险,39.5%(196/496)的患者存在营养不良。年龄≥70岁的胃部肿瘤患者,营养风险和营养不良的发生率最高。营养治疗方式上,200例患者接受了饮食+营养教育,21例接受了饮食+口服营养补充(ONS),仅5例给予全肠内营养(TEN)。270例患者接受了肠外营养(PN),其中137例给予全肠外营养(TPN),133例给予肠外联合肠内营养治疗。PN输注方式上,多瓶串输占71.5%(193/270),商品化全合一占18.5%(50/270),个体化全合一占10.0%(27/270)。PN输注途径上,经外周静脉输注占89.2%(241/270),经外周穿刺置入中心静脉导管(PICC)占6.7%(18/270),中心静脉置管(CVC)占4.1%(11/270)。90.1%的医院认可将营养治疗纳入肿瘤患者的整体治疗,36.4%的医院成立了营养支持小组(NST),54.5%的医院配备了专职营养药师。结论:老年消化系统恶性肿瘤患者营养风险及营养不良发生率较高。虽然多数医院已将营养治疗纳入肿瘤患者的整体治疗并开展了营养风险筛查工作,但营养干预手段和营养药物的使用仍存在诸多不合理现象,仍需通过学科协作模式早日规范消化系统恶性肿瘤患者,尤其是老年患者的营养治疗。OBJECTIVE By referring to the NutritionDay questionnaire of European Association of Parenteral & Enteral Nutrition, nutritional status and using nutritional drugs for 534 patients with malignant digestive system tumors were evaluated at some tertiary hospitals in Anhui area.METHODS The NutritionDay questionnaire was designed and revised by adopting a cross-sectional survey method.We collected basic profiles, nutritional risk, nutritional status, nutritional intervention, nutritional drug using and development of nutritional treatment of adult inpatients diagnosed with digestive system malignancies at 11 comprehensive Class Ⅲ hospitals in Anhui on December 5, 2018.RESULTS Among them, 38 unqualified questionnaires were excluded and 496 valid questionnaires collected.And 70.2%(348/496) had nutritional risks and 39.5%(196/496) developed malnutrition.The incidence of nutritional risk and malnutrition was highest in patients with gastric cancer aged≥70 years.Among 496 patients, 200 patients received diet plus nutrition tutorial, 21 patients diet plus oral nutritional supplements(ONS) and 5 patients standardized total intestinal nutrition(TEN).The regimens were parenteral nutrition(PN, n=270), total parenteral nutrition(TPN, n=137) and parenteral plus enteral nutrition(n=133).In terms of PN infusion, multi-bottle serial infusion accounted for 71.5%(193/270), commercial all-in-one infusion 18.5%(50/270) and individual all-in-one infusion 10.0%(27/270).And 89.2% of them received PN via peripheral veins, 6.7% via peripherally inserted central catheter(PICC) and 4.1% via central venous catheter(CVC).Up to 90.1% of hospitals approved the inclusion of nutritional therapy in the overall treatment of cancer patients, 36.4% of hospitals have established nutrition support team(NST) and 54.5% of hospitals were staffed with full-time nutritional pharmacist.CONCLUSION The incidence of nutritional risk and malnutrition is higher in elders with malignant digestive system tumors.Although most hospitals have included nutritional the

关 键 词：营养日 消化系统恶性肿瘤 营养风险 营养干预 营养药物 

分 类 号：R969.3[医药卫生—药理学]