重视外科患者的营养风险与全程营养管理
Emphasizing nutritional risk in surgical patients and implementing comprehensive nutritional management
于健春1
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院基本外科,北京 100730
- 折叠
摘要
临床营养学作为外科患者治疗的重要组成部分,经过60余年的发展,已成为挽救肠功能衰竭或疑难病患生命的关键技术.然而,在21世纪仍缺乏及时有效的营养筛查和干预,导致不良预后的问题凸显.微创手术虽然带来益处,但在胃肠外科领域,营养风险或不良的比例仍然超过50％.因此本文探讨了外科患者面临的营养风险和全程营养管理的重要性.首先,重新认识外科患者的营养风险和营养不良的情况,指出在经济增长和生活方式变化背景下,慢性疾病增加,特别是肿瘤、老年共病患者和炎症性肠病患者面临较高的营养风险.其次,强调了临床营养指南和共识在外科实践中的重要性,并通过多项研究证实了这些指南的有效性.最后,文中详细讨论了外科患者的全程营养管理,包括营养风险筛查、评估、诊断以及营养支持治疗的重要性,特别是在胃肠大手术后的早期和恢复期.本文旨在提高外科医师和医护工作者对营养管理的认识,以改善患者的临床预后和生活质量.
Abstract
Over the past 60 years,clinical nutrition has evolved into a key technology for saving the lives of patients with intestinal failure or complex diseases.However,the 21st century has seen issues with adverse outcomes due to a lack of timely and effective nutritional screening and intervention.Despite the benefits of minimally invasive surgery,nutritional risks or adverse outcomes still exceed 50％in gastrointestinal surgery.The study explores the importance of comprehensive nutritional management for surgical patients,beginning with a reevaluation of their nutritional risks and malnutrition,especially in the context of increasing chronic diseases like cancer,elderly comorbidities,and inflammatory bowel disease.It emphasizes the importance of clinical nutrition guidelines and consensus in surgical practice validated by various studies.The article then details the comprehensive nutritional management of surgical patients,including the importance of nutritional risk screening,assessment,diagnosis,and nutritional support treatment,especially during the early and recovery phases of major gastrointestinal surgery.The aim is to enhance the awareness of surgeons and healthcare workers about nutritional management to improve patients'clinical outcomes and quality of life.
关键词
营养科学/营养不良/营养支持Key words
Nutritional sciences/Malnutrition/Nutritional support引用本文复制引用
基金项目
中央高水平医院临床科研业务费项目(2022-PUMCH-B-005)
国家重点研发计划(2022YFF1100400)
出版年
2024
NETL
NSTL
万方数据