全程化营养管理在胸腹腔镜食管癌根治术患者中的应用  

Application of whole-process nutritional management in patients undergoing thoracoabdominal laparoscopic radical esophagectomy

作　　者：朱文静 丁敏 丁媛 张杰 钱晨 Zhu Wenjing;Ding Min;Ding Yuan;Zhang Jie;Qian Chen(Operating Room,Jiangsu Institute of Cancer Research(Jiangsu Cancer Hospital,the Affiliated Cancer Hospital of Nanjing Medical University),Nanjing 210009,China;Department of Thoracic Surgery,Jiangsu Institute of Cancer Research(Jiangsu Cancer Hospital,the Affiliated Cancer Hospital of Nanjing Medical University),Nanjing 210009,China)

机构地区：[1]江苏省肿瘤防治研究所(江苏省肿瘤医院或南京医科大学附属肿瘤医院)手术室,南京210009 [2]江苏省肿瘤防治研究所(江苏省肿瘤医院或南京医科大学附属肿瘤医院)胸外科,南京210009

出　　处：《中华现代护理杂志》2024年第32期4438-4442,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨全程化营养管理在胸腹腔镜食管癌根治术患者中的应用效果。方法采用便利抽样法,选取2022年2月—2024年2月在江苏省肿瘤医院接受胸腹腔镜食管癌根治术的144例患者为研究对象。采用随机数字表法将患者分为对照组(n=72)和观察组(n=72)。对照组采用常规护理模式,观察组在对照组的基础上实施全程化营养管理。比较两组患者营养情况、术后恢复情况、护理满意度和体重丢失情况。结果术前1 d观察组营养风险筛查评估表评分低于对照组,差异有统计学意义(P<0.05)。观察组食管癌患者的首次下床时间、首次排便时间、首次排气时间、并发症总例数均低于对照组,差异均有统计学意义(P<0.05)。观察组食管癌患者护理满意度评分表各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者术后1个月体重丢失低于对照组,差异有统计学意义(P<0.05)。结论全程化营养管理可改善食管癌患者术前营养状况评分,减少术后并发症发生,降低体重丢失,提升患者护理满意度。Objective To explore the application effects of whole-process nutritional management in patients undergoing thoracoabdominal laparoscopic radical esophagectomy.MethodsA total of 144 patients who underwent thoracoabdominal laparoscopic radical esophagectomy at the Jiangsu Cancer Hospital between February 2022 and February 2024 were selected using convenience sampling method.Patients were randomly assigned to a control group(n=72)receiving routine care and an observation group(n=72)receiving whole-process nutritional management in addition to routine care.Nutritional status,postoperative recovery,nursing satisfaction,and weight loss were compared between the two groups.Results On the day before surgery,the Nutritional Risk Screening(NRS-2002)score of the observation group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).The observation group had earlier times to first ambulation,bowel movement,flatus,and fewer total complications compared to the control group,the differences were statistically significant(P<0.05).Nursing satisfaction scores in the observation group were significantly higher than in the control group,the differences were statistically significant(P<0.05).One month postoperatively,the observation group experienced less weight loss than the control group,the difference was statistically significant(P<0.05).Conclusions Whole-process nutritional management improves preoperative nutritional status scores,reduces postoperative complications and weight loss,and enhances patient satisfaction with nursing care in esophageal cancer patients undergoing thoracoabdominal laparoscopic radical esophagectomy.

关 键 词：食管癌 全程化 营养管理 营养风险 术后恢复 体重 满意度 

分 类 号：R473.73[医药卫生—护理学]