胆管癌患者围手术期营养支持中国专家共识(2023版)  

Chinese expert consensus on perioperative nutritional support for patients with cholangio-carcinoma(2023 edition)

作　　者：中国抗癌协会肝胆肿瘤整合护理专业委员会 重庆市医学会肝胆胰外科分会 重庆市护理学会肝胆外科护理专业委员会 吴英 黄中英[3] 冷雅楠 王宗华 袁侨英 曾媛 Hepatobiliary Tumor Integrated Nursing Committee of Chinese Anti-Cancer Association;Chongqing Medical Association Hepatobiliary Pancreatic Surgery Branch;Hepatobiliary Surgery Nursing Professional Committee of Chongqing Nursing Society;Wu Ying;Huang Zhongying(不详;Department of Hepatobiliary Surgery,the First Afiliated Hospital of Army Medical University,Chongqing 400038,China;Nursing Department of Huangpu Hospital,Sun Yat-sen University Cancer Center,Guangzhou 510062,China)

机构地区：[1]不详 [2]陆军军医大学第一附属医院肝胆外科,重庆400038 [3]中山大学肿瘤防治中心黄埔院区护理部,广州510062 [4]陆军军医大学第一附属医院 [5]陆军军医大学

出　　处：《中华消化外科杂志》2023年第8期943-952,共10页Chinese Journal of Digestive Surgery

基　　金：重庆市卫生健康委医学科研项目(2022WSJK082)。

摘　　要：目的制订胆管癌患者围手术期营养支持中国专家共识,为临床医务人员开展针对胆管癌患者的规范化营养支持提供参考。方法通过系统检索、评价和汇总胆管癌患者围手术期营养支持的最佳证据,形成共识初稿;采用德尔菲专家函询形成推荐级别,并通过专家现场论证对共识初稿和推荐级别进行讨论与修改,最终形成终稿。结果共识从组建营养支持多学科团队,营养风险筛查、评估与诊断,营养支持适应证,围手术期能耗需求,营养支持启动时机及时长,营养支持方式的选择,胆汁回输的应用,营养支持的实践,营养随访9个方面达成一致性意见。结论共识形成基于循证医学依据的胆管癌患者围手术期营养支持推荐意见,以期为医务人员制订科学化、规范化及全程化的营养支持方案提供依据和参考。Objective To establish an expert consensus on perioperative nutritional support for patients with cholangiocarcinoma,and to provide reference for clinical staff to carry out standardized nutritional support for patients with cholangiocarcinoma.Methods By systema-tically searching,evaluating and summarizing the best evidence of perioperative nutritional support for patients with cholangiocarcinoma,a draft consensus was formed.The recommendation level was formed by Delphi expert consultation,and the consensus draft and recommendation level were discussed and modified through on-site expert demonstration,and the final draft was formed.Results The expert consensus was reached including nine aspects:the establishment of multi-disciplinary nutritional support team,nutritional risk screening,evaluation and diagnosis,indications of nutritional treatment,perioperative energy consumption demand,timing and duration of nutri-tional support initiation,choice of nutritional support mode,application of bile transfusion,nutri-tional support practices,and nutritional follow-up.Conclusions This consensus can provide evidence-based reference for the formulation of scientific,standardized and whole-process nutritional support programs for patients.Medical staff can apply this consensus to clinical practice in combination with department resources and patients′actual needs.

关 键 词：胆管肿瘤 围手术期 营养支持 专家共识 德尔菲法 

分 类 号：R735.8[医药卫生—肿瘤]