中国实用外科杂志

• 论蓍 • 上一篇    下一篇

肿瘤住院病人营养治疗现状多中心调查报告

孙海峰1,章    黎1,万松林1王蕾蕾2张片红2李徐奇3王曙逢3康维明4,陈    伟4,郭淑丽4,李子建4,陈莲珍5,吴健雄5,陈俊强6,吴向华6,董    洋7,刘小孙7,张新胜8,唐    云8,刘英华8,于健春4,王新颖1   

  1. 1 中国人民解放军南京总医院普通外科,江苏南京210002;2 浙江大学附属第二医院营养科,浙江杭州310009;3 西安交通大学第一附属医院普通外科,陕西西安710061;4 北京协和医院基本外科,北京100730;5 中国医学科学院肿瘤医院,北京100021;6 广西医科大学第一附属医院,广西南宁530021;7 浙江大学第一附属医院胃肠外科,浙江杭州310006;8 中国人民解放军总医院营养科,北京100853
  • 出版日期:2018-06-01 发布日期:2018-06-21

  • Online:2018-06-01 Published:2018-06-21

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。

关键词: 肿瘤住院病人, 营养支持, 营养风险, 营养不良, 世界营养日

Abstract:

A comprehensive nutritional survey of oncology inpatients        SUN Hai-feng*, ZHANG Li, WAN Song-lin ,et al. *Clinical Nutrition Center, Department of General Surgery, Jinling Hospital of Nanjing University; Nanjing General Hospital,Nanjing 210002, China
Corresponding authors: WANG Xin-ying, E-mail: wangxinying@nju.edu.cn; YU Jian-chun, E-mail:yu-jch@163.com
SUN Hai-feng, ZHANG Li and WAN Song-lin are the first authors who contributed equally to the article
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). About 74.4% (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. And 33.3% of malnutrition patients and 46.9% of patients with nutritional risk did not receive nutritional support,whereas 51.0% 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.

Key words: oncology inpatient, nutritional support, nutritional risk, malnutrition, Nutrition Day