根治性全膀胱切除患者围手术期营养管理方案的构建  

Construction of perioperative nutritional management plan for patients undergoing radical total cystectomy

作　　者：张磊[1] 张宇 李欣[2] Zhang Lei;Zhang Yu;Li Xin(Department of Urology Surgery,Beijing University&National Research Center for Geriatrics&Research Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China;Nursing Department,Beijing University&National Research Center for Geriatrics&Research Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科国家老年医学研究中心中国医学科学院老年医学研究院,北京100730 [2]北京医院护理部国家老年医学研究中心中国医学科学院老年医学研究院,北京100730

出　　处：《中华现代护理杂志》2023年第27期3724-3730,共7页Chinese Journal of Modern Nursing

摘　　要：目的基于循证理念构建根治性全膀胱切除患者围手术期营养管理方案。方法检索国内外高质量文献,拟定根治性全膀胱切除患者围手术期营养管理方案初稿,于2022年7—9月应用德尔菲法对16名专家进行函询,形成根治性全膀胱切除患者围手术期营养管理方案终稿。结果共进行2轮专家咨询,有效回收率均为100.00%。2轮函询专家相同,专家的权威系数为0.963;第1、2轮专家函询中分别有10、4名专家提出修改意见。第1轮专家咨询一、二、三级指标的肯德尔和谐系数为0.092~0.169(P<0.05);第2轮专家咨询一、二、三级指标的肯德尔和谐系数为0.201~0.223(P<0.05)。第2轮咨询各指标变异系数为0.05~0.22。最终确定的根治性全膀胱切除患者围手术期营养管理方案包括一级指标5项、二级指标15项、三级指标41项。结论基于循证理念构建的根治性全膀胱切除患者围手术期营养管理方案具有科学性、针对性和实用性,可为临床实践提供借鉴。ObjectiveTo construct a perioperative nutritional management plan for patients undergoing radical total cystectomy based on an evidence-based concept.MethodsWe searched high-quality literature both domestically and internationally to draft a preliminary perioperative nutritional management plan for patients undergoing radical total cystectomy.From July to September 2022,16 experts were consulted by Delphi method,and the final perioperative nutritional management plan for patients undergoing radical total cystectomy was formed.ResultsTwo rounds of expert consultation were conducted,with an effective recovery rate of 100.00%.Two rounds of consultation with experts were the same,with an authority coefficient of 0.963.In the first and second rounds of expert consultations,10 and 4 experts respectively proposed modification suggestions.In the first round of expert consultation,the Kendal concordance coefficient of the first,second and third level indicators was 0.092 to 0.169(P<0.05).In the second round of expert consultation,the Kendal concordance coefficient of the first,second and third level indicators was 0.201 to 0.223(P<0.05).The coefficient of variation of each indicator in the second round of consultation was 0.05 to 0.22.The final perioperative nutritional management plan for patients undergoing radical total cystectomy included 5 first level indicators,15 second level indicators,and 41 third level indicators.ConclusionsThe perioperative nutritional management plan for patients undergoing radical total cystectomy based on evidence-based concepts is scientific,targeted,and practical,which can provide reference for clinical practice.

关 键 词：膀胱肿瘤 根治性膀胱切除术 德尔菲法 营养管理 

分 类 号：R473.73[医药卫生—护理学]