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肿瘤住院病人营养治疗现状多中心调查报告

A comprehensive nutritional survey of oncology inpatients

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【作者】 孙海峰章黎万松林王蕾蕾张片红李徐奇王曙逢康维明陈伟郭淑丽李子建陈莲珍吴健雄陈俊强吴向华董洋刘小孙张新胜唐云刘英华于健春王新颖

【Author】 SUN Hai-feng;ZHANG Li;WAN Song-lin;WANG Xin-ying;YU Jian-chun;Clinical Nutrition Center, Department of General Surgery, Jinling Hospital of Nanjing University; Nanjing General Hospital;

【通讯作者】 于健春;王新颖;

【机构】 中国人民解放军南京总医院普通外科浙江大学附属第二医院营养科西安交通大学第一附属医院普通外科北京协和医院基本外科中国医学科学院肿瘤医院广西医科大学第一附属医院浙江大学第一附属医院胃肠外科中国人民解放军总医院营养科

【摘要】 目的分析肿瘤住院病人的营养状况、营养治疗现状及意义。方法分析2016年中国"世界营养日"调查数据,纳入来自中国华北、华南、西北及西南地区的8家大型三甲医院肿瘤住院病人共306例,收集并分析其疾病信息、营养治疗及30 d预后信息。结果该306例住院病人营养风险及营养不良总发生率为51.3%(157/306),其中营养不良发生率为35.3%(108/306),其中肠外营养应用率达45.8%(140/306)。74.4%(218/293)的病人能从营养治疗中获益。营养支持可明显改善有营养风险或营养不良肿瘤病人的30 d预后,但对营养状况良好者效果不明显。33.3%的营养不良的肿瘤病人和46.9%的存在营养风险的肿瘤病人没有接受营养干预,而营养状况良好的肿瘤病人被施以营养治疗的比例高达51.0%。病人营养状况、住院期间手术、自评健康状况是我国肿瘤住院病人30 d预后的危险因素。结论我国肿瘤住院病人营养风险及营养不良发生率高,营养支持实施不够规范,对于自评健康状况差、晚期肿瘤失去手术机会、营养状况差的肿瘤病人应及时制定针对性治疗措施。

【Abstract】 Objective To provide a comprehensive description of the nutritional characteristics,nutritional support and its importance among oncology inpatients. Methods The data from Nutrition Day 2016 about 306 oncology inpatients from 8 domestic hospitals were enrolled. Information of nutrition support and 30-day outcomes were collected and analyzed. Results The incidence of nutritional risk or malnutrition in oncology inpatients was 51.3%(157/306).Among them,malnutrition rate was 35.3%(108/306),and parenteral nutrition using rate was 45.8%(140/306). About74.4%(218/293)patients believed they could benefit from the nutrition therapy. The nutrition therapy improved 30-day outcomes of oncology inpatients with nutritional risk or malnutrition,but had no effect on those well nourished. And33.3% of malnutrition patients and 46.9% of patients with nutritional risk did not receive nutritional support,whereas51.0% well-nourished patients did. Nutritional status,operation during hospital stay and self-rated health were risk factors of 30-day outcomes for oncology inpatients. Conclusion The prevalence of nutritional risk and malnutrition is still high and associated with poor 30-day outcomes. Nutritional treatment is not standardized enough in domestic hospitals. Specific interventions should be considered for oncology inpatients with poor self-rated health,lost operation opportunity and poor nutrition status in terminal stage.

【基金】 外科规范化临床营养支持治疗体系的建立与推广(No.201502022);南京大学博士研究生创新创意研究计划项目(No.CXCY17-28)
  • 【文献出处】 中国实用外科杂志 ,Chinese Journal of Practical Surgery , 编辑部邮箱 ,2018年06期
  • 【分类号】R730.5
  • 【被引频次】13
  • 【下载频次】537
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