肝母细胞瘤患儿围术期及术后居家营养干预方案构建及临床应用  

Construction and clinical application of a perioperative and postoperative home nutritional intervention regimen for children with hepatoblastoma

作　　者：张娟[1] 郝希伟[1] 李丹[2] 刘琳[1] 刘晶晶[1] 魏丽丽[3] ZHANG Juan;HAO Xiwei;LI Dan;LIU Lin;LIU Jingjing;WEI Lili(Department of Pediatric Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院小儿外科,山东青岛266003 [2]青岛大学附属医院急诊内科,山东青岛266003 [3]青岛大学附属医院护理部,山东青岛266003

出　　处：《精准医学杂志》2024年第5期439-443,共5页Journal of Precision Medicine

基　　金：国家自然科学基金项目(82293665)。

摘　　要：目的构建肝母细胞瘤患儿围术期及术后居家营养干预方案,并对其临床应用效果进行评估。方法采用半结构式访谈、文献研究法和德尔菲法构建肝母细胞瘤患儿围术期及术后营养干预方案。选取2019年1月—2021年8月我院手术的31例肝母细胞瘤患儿作为对照组,2021年9月—2023年12月手术的31例肝母细胞瘤患儿作为试验组,对照组采用常规诊疗护理,试验组在对照组基础上实施营养干预方案。通过比较不同干预措施下两组患儿术前1周、术后1周、术后1月、术后3月的营养状况和血生化(血清白蛋白、血清前白蛋白、血液血红蛋白)指标,以及身高、体质量和体质量指数,评估营养干预方案临床指导意义与实际效果。结果术后1、3月时,与对照组比较,试验组患儿轻中度和重度营养不良人数明显减少(Z=-2.799、-3.697,P<0.05),血清白蛋白、血液血红蛋白水平显著升高(F=4.870~111.680,P<0.05);术后1、3月与术前1周比较,两组患儿血清前白蛋白和血液血红蛋白均显著升高(F=60.247~1270.148,P<0.05);试验组术后1、3月时的体质量变化(与术前1周比较)显著高于对照组(Z=-2.405、-4.716,P<0.05)。结论成功构建了肝母细胞瘤患儿围手术期及术后居家营养干预方案,研究发现干预方案可改善患儿营养状况、血生化指标及体格发育情况,具有较好的科学性和实用性。Objective To construct a perioperative and postoperative home nutritional intervention regimen for children with hepatoblastoma,and to evaluate its clinical application effect.Methods Semi-structured interviews,literature research,and Delphi methods were used to construct a perioperative and postoperative nutritional intervention regimen for children with he-patoblastoma.A total of 31 children with hepatoblastoma who underwent surgery in our hospital from January 2019 to August 2021 were enrolled as control group,and 31 children with hepatoblastoma who underwent surgery from September 2021 to December 2023 were enrolled as experimental group.The children in the control group received routine diagnosis,treatment,and nursing,and those in the experimental group received the nutritional intervention regimen in addition to the intervention in the control group.The two groups were compared in terms of nutritional status,blood biochemical parameters(serum albumin,serum prealbumin,and blood hemoglobin),body height,body weight,and body mass index at 1 week before surgery and at 1 week,1 month,and 3 months after surgery,and the clinical guiding significance and practical effect of the nutritional intervention regimen was assessed.Results At 1 and 3 months after surgery,compared with the control group,the experimental group had a significant reduction in the numbers of children with mild-to-moderate malnutrition and severe malnutrition(Z=-2.799,-3.697,P<0.05)and significant increases in the levels of serum albumin and blood hemoglobin(F=4.870-111.680,P<0.05).At 1 and 3 months after surgery,both groups had significant increases in serum albumin and hemoglobin compared with the data at 1 week before surgery(F=60.247-1270.148,P<0.05),and compared with the control group,the experimental group had significantly greater changes in body weight at 1 and 3 months after surgery(compared with the data at 1 week before surgery)(Z=-2.405,-4.716,P<0.05).Conclusion This study successfully constructs a perioperative and postoperative home

关 键 词：肝胚细胞瘤 围手术期护理 手术后医护 家庭医疗保健服务 营养疗法 

分 类 号：R735.7[医药卫生—肿瘤] R459.3[医药卫生—临床医学]