营养专科护士主导的目标执行管理模式对胃肠道肿瘤病人围术期口服营养补充依从性的效果研究  

The effect of nutrition specialist nurse-led target execution management mode on perioperative oral nutritional supplement compliance in patients with gastrointestinal tumors

作　　者：刘莹[1] 李婷[1] 侯海燕[1] 康维明[1] 于健春[1] 叶欣[1] 郭淑丽[1] LIU Ying;LI Ting;HOU Hai-yan;KANG Wei-ming;YU Jian-chun;YE Xin;GUO Shu-li(General Surgery Ward 4 Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《肠外与肠内营养》2023年第3期160-165,共6页Parenteral & Enteral Nutrition

基　　金：中央高水平医院临床科研业务费[2022-PUMCH-B-031]。

摘　　要：目的:探讨营养专科护士主导的目标执行管理模式对于改善胃肠道恶性肿瘤病人围术期口服营养补充(ONS)依从性和营养状况的效果。方法:招募2020年12月1日至2021年11月30日收治北京协和医院胃肠外科的76例胃肠道恶性肿瘤病人并进行随机分组,对照组予以常规营养支持护理,研究组由营养专科护士主导的营养支持小组(NST)提供以目标执行管理理念为核心的营养管理模式,包括制定目标执行计划、营养耐受性监测及针对性干预等。结果:对照组、研究组术前平均每日ONS摄取能量无显著性差异[(1094.05±201.13)kcal/d vs(1180.84±235.99)kcal/d];与对照组病人相比,研究组病人术后平均每日ONS摄取能量[(484.57±191.86)kcal/d vs(774.78±273.34)kcal/d]、平均每日肠内营养摄取能量[(522.04±193.26)kcal/d vs(805.29±106.23)kcal/d]、平均每日ONS达标率(63.17%±24.23%vs 101.84%±10.36%)及体质量、白蛋白、前蛋白等营养指标有显著性提高,术后喂养不耐受发生情况减少(P均<0.05)。结论:营养专科护士主导的目标执行管理模式可改善胃肠道恶性肿瘤病人术后ONS依从性及机体营养状况。Objective:To investigate the effect of target execution management model led by nutrition specialist nurse on improving ONS perioperative compliance and nutritional status of patients with gastrointestinal malignant tumors.Methods:From December 1,2020 to November 30,2021,76 patients with gastrointestinal malignant tumors admitted to the department of gastrointestinal surgery of Peking Union Medical College Hospital were recruited and randomized into two groups.The control group received routine nutritional support and nursing.the nutrition support group(NST)led by nutrition specialist nurses in the study group provided a nutrition management model with target execution management concept as the core,including formulating target implementation plans,nutritional tolerance monitoring and targeted interventions.Results:There was no significant difference between the control group and the study group in the average daily energy intake of ONS before surgery[(1094.05±201.13)kcal/d vs(1180.84±235.99)kcal/d].Compared to control patients,in the study group,the average daily energy intake of ONS[(484.57±191.86)kcal/d vs(774.78±273.34)kcal/d],the average daily energy intake of enteral nutrition[(522.04±193.26)kcal/d vs(805.29±106.23)kcal/d],the average daily rate of reaching the standard of ONS[(63.17%±24.23%)vs(101.84%±10.36%)],and the nutritional indicators such as body mass,albumin,and protein in the study group were significantly increased,and the incidence of postoperative feeding intolerance was decreased(P<0.05 for each).Conclusion:The target execution management model led by nutrition specialist nurses can improve postoperative ONS compliance and nutritional status of patients with gastrointestinal malignant tumors.

关 键 词：目标执行管理 口服营养补充 依从性 

分 类 号：R459.3[医药卫生—治疗学]