基于个案管理的营养干预在胃癌术后患者中疗效评价  

Effect evaluation of nutritional intervention based on case management in patients after radical gastrectomy for gastric cancer

作　　者：周华丽[1] 马洪丽[1] 赵法之 何维阳 顾琼[1] 保蓉[1] Zhou Huali;Ma Hongli;Zhao Fazhi;He Weiyang;Gu Qiong;Bao Rong(The Second Ward of Gastroenteric Surgery,Sichuan Cancer Hospital,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院胃肠外科中心二病区,成都610041

出　　处：《肿瘤代谢与营养电子杂志》2022年第1期74-79,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：四川省护理学会课题(H18051)。

摘　　要：目的探究个案管理中的营养干预在胃癌根治术后患者中的效果。方法采用真实数据研究的方法,按照手术时间先后顺序将患者分为两组。2017年11月至2018年10月行胃癌根治术患者为对照组173例,对照组患者住院期间,完成所有筛查、评估、治疗,根据胃肠功能情况,由主管医师、护士、营养师每日查房后指导患者进食,出院日由主管护士为患者发放胃癌手术患者饮食指导手册,在术后1个月、2个月、3个月、6个月完成相关随访内容;2018年11月至2019年10月行胃癌根治术患者为试验组166例,试验组患者在住院期间得到相同的指导,出院后由专门的个案管理师进行随访(包括患者及家属),了解患者居家期间营养状况并给予指导,比较两组患者营养风险、营养不良发生情况、血红蛋白、血清总蛋白、前白蛋白、白蛋白、体重增加及肱三头肌皮褶厚度、右手握力及并发症发生情况。结果166例患者完成本次研究,在不考虑时间累积效应对结果的影响下,通过在个案管理中实施营养干预,试验组在调查的不同时期,营养风险、营养不良发生率均低于对照组,试验组营养风险、营养良好、血红蛋白、血清总蛋白、前白蛋白、白蛋白、体重增加及肱三头肌皮褶厚度与对照组比较差异均有统计学意义(P<0.05)。结论实施胃癌根治术患者个案管理中的营养干预,有助于改善患者错误的饮食观念,改善患者的营养状况。Objective To explore the effect of nutritional intervention in case management on patients after radical gastrectomy for gastric cancer.Method Using real data studies,patients were divided into two groups according to the chronological order of surgery.In November 2017 to October 2018 as control group,173 cases of patients with gastric cancer radical,control group patients during hospitalization,complete all screening,assessment,treatment,according to the situation of gastric bowel function,by the competent physicians,nurses,dietitians daily rounds to guide patients to eat,after hospital discharge,by the competent nurses for patients with gastric cancer surgery patients diet instruction manual,follow⁃up was completed at 1,2,3 and 6 months postoperatively.166 patients in the experimental group underwent radical gastritis from November 2018 to October 2019.Patients in the experimental group received the same guidance during hospitalization,and were followed up by special case managers(including patients and their families)after discharge to understand the nutritional status of patients at home and give guidance.Nutritional risk,incidence of malnutrition,hemoglobin,serum total protein,prealbumin,albumin,weight gain,triceps dermal fold thickness,right hand grip strength and incidence of complications were compared between 2 groups.Result 166 patients completed the study.Without considering the effect of time accumulation on the results,nutrition intervention was implemented in case management.The nutritional risk and malnutrition incidence of the experimental group were lower than those of the control group at different periods of the investigation.Nutritional risk,good nutrition,hemoglobin,serum total protein,prealbumin,albumin,body weight gain and triceps skin fold thickness of the experimental group were significantly different from those of the control group(P<0.05).Conclusion Nutritional intervention in case management of patients undergoing radical gastrectomy for gastric cancer is helpful to improve patients

关 键 词：胃癌 胃切除术 个案管理 营养 

分 类 号：R473.73[医药卫生—护理学]