[1]张 婷,杨 丽,沈 芳.团队协作干预在胰腺癌术后家庭肠内营养病人中的应用效果研究[J].肠外与肠内营养杂志,2019,(04):212-218.[doi:DOI : 10.16151/j.1007-810x.2019.04.005]
 ZHANG Ting,YANG Li,SHEN Fang.Team collaboration promotes home enteral nutrition in patients after pancreatectomy[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):212-218.[doi:DOI : 10.16151/j.1007-810x.2019.04.005]
点击复制

团队协作干预在胰腺癌术后家庭肠内营养病人中的应用效果研究
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2019年04期
页码:
212-218
栏目:
论著
出版日期:
2019-07-10

文章信息/Info

Title:
Team collaboration promotes home enteral nutrition in patients after pancreatectomy
作者:
张 婷杨 丽沈 芳
上海交通大学医学院附属仁济医院胆胰外科,上海 200127
Author(s):
ZHANG Ting YANG Li SHEN Fang
Department of Biliary and Pancreatic Surge,Shanghai Jiaotong University School of Medicine Affiliate Renji Hospital, Shanghai 200127, China
关键词:
胰腺癌术后 家庭肠内营养 团队协作干预
Keywords:
Pancreatectomy Home enteral nutrition Nutrition support Team collaboration
分类号:
R473.6, R735.9
DOI:
DOI : 10.16151/j.1007-810x.2019.04.005
文献标志码:
A
摘要:
目的:通过团队协作干预的方法,提高胰腺癌术后病人的营养风险、体力状况和生活质量。 方法:采用随机数表法将 72名符合要求的病人随机分组,干预组采用团队协作干预方法进行干预和随访,对照组进行常规干预和随访,在干预 1个月、3个月和 6个月后分别记录两组病人执行家庭肠内营养的情况(制剂选择、给予方式选择和并发症发生情况)和两组病人营养风险(NRS 2002)、体力状况(ZPS)和生活质量(QLQ30)得分情况。 结果:两组病人在干预前并发症发生例数上均无显著性差异(P > 0.05),在干预 1个月、3个月和 6个月后并发症发生例数差异均有统计学意义(P < 0.05);营养风险:拒绝球形检验(P < 0.01),NRS 2002得分随时间的推移而改变,且在两组间的差异有统计学意义,干预组营养风险显著优于对照组,时间和分组有交互作用(P < 0.05);体力状况:拒绝球形检验(P < 0.01),病人 ZPS得分随时间的推移而改变,时间和分组有交互作用,干预 1个月和 3个月后,对照组得分趋势显著低于干预组,干预 6个月后,干预组得分趋势显著低于对照组(P < 0.05);生活质量:接受球形检验(P > 0.05),病人 QLQ30随时间的推移而改变,时间和分组有交互作用,在干预 1个月和 3个月后,两组病人 QLQ得分差异无统计学意义,在干预 6个月后干预组病人 QLQ30得分显著优于对照。 结论:团队协作干预方法对胰腺 癌术后家庭肠内营养的病人在并发症的发生、营养风险、体力状况和生活质量有一定的效果,体力状况和生活质量的变化在干预 6个月时效果相对明显。
Abstract:
Objective: To improve the postoperative nutritional status, physical condition and quality of life in patients with pancreatic cancer by team collaboration intervention. Methods: A total of 72 qualified patients were randomly assigned into team collaboration intervention and comparison groups. Home enteral nutrition administration (choice of preparation, prescription method and complication), nutritional status (NRS 2002), physical condition (ZPS) and quality of life (QLQ30) scores at 1, 3 and 6 months were recorded. Results: no significant difference in complications was observed before intervention (P > 0.05) while complications in team collaboration intervention were significantly less than those in comparison team after 1, 3 and 6-months intervention (P < 0.05). NRS 2002 score was significantly higher in nutrition intervention group compared to control group (P < 0.05). ZPS score was significantly lower in control group after 1 and 3 months, but higher after 6 month compared to intervention group (P < 0.05). QLQ30 score was similar between two groups after 1 and 3 month, but was higher in intervention group after 6 month. Conclusion: nutritional support team collaboration improves nutritional status, physical condition and quality of life in patients with pancreatic cancer during home enteral nutrition administration.

参考文献/References:


[1] La Torre M, Ziparo V, Nigri G, et al. Malnutrition and pancreatic surgery: Prevalence and outcomes. J Surg Oncol, 2013, 107(7):702-708.
[2] 李湘成, 杨 林 . 改善胰腺癌患者手术预后的研究进展 . 医学综述,2013, 19(2): 262-265.
[3] 刘佩玉, 李 丽, 叶志霞 . 胰腺癌患者手术后营养支持体验的质性研究 . 护理学杂志, 2016, 31(20): 25-28.
[4] 中华医学会 .体能状态评分 ECOG评分法 . 中华普通外科学文献(电子版),2012,6(6):556.
[5] Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4): 415-421.
[6] 万崇华, 陈明清, 张灿珍, 等 . 癌症患者生命质量测定量表EORTC-QLQC30 中文版评介 . 实用肿瘤杂志 , 2005, 20(4):353-355.
[7] 张忠涛,蔡 军 . 胰腺癌多学科综合治疗协作组诊疗模式专家共识 . 中国实用外科杂志,2017,37(1):35-36.
[8] Fogel Evan L, Shahda Safi , Sandrasegaran Kumaret al. A Multidisciplinary Approach to Pancreas Cancer in 2016: A Review. Am J Gastroenterol, 2017, 112(4): 555.
[9] Alivizatos V. Gavala V. Alexopoulos P,et al. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition. Indian J palliate Care, 2012, 18(1): 31-33.
[10] Martins AS, Rezende NA, Torres HO. Occcurence of complications and survival rates in elderly with neurological disorders undergoing enteral nutrition therapy. Rev Assoc Med Bras(1992), 2012,58(6):691-697.
[11] Kalita M, Majewsla K, Gradowska A, et al. Food, mechanic and septic complications in patients enterally nutritioned in home conditions. Pol Przegl Chir, 2015,86(10):466-472.
[12] Dinenage S, Gower M, Van Wyk J, et al. Development and evaluation of a home enteral nutrition team. Nutrients, 2015, 7(3):1607-1617.
[13] DeLegge MH, Kelly AT. State of nutrition support team.Nutr Clin Pract, 2013,28(6):691-697
[14] 黄迎春,王新颖,彭南海 . 营养支持小组在家庭肠内营养中的应用 . 肠外与肠内营养,2009,16(3):191-192.
[15] 黄迎春,王新颖,彭南海 . 家庭肠内营养电话随访结果分析 . 肠外与肠内营养, 2011,18(2):125-126.
[16] Boisseau N, Burde A, Bachman P, et al. A telephone-linked computer system for home enteral nutrition. J Telemed Telecare,2010, 16(7):363-367
[17] 谢绮雯,伍丽霞,陈欣智, 等 . 家庭肠内营养病人护理随访效果分析 . 护理研究,2012,26(16):1528-1529.
[18] 王广胜 . 胰腺癌术后肠内营养护理的应用 . 中国医药导报,2013, 10(9): 133-135.
[19] Hari M, Rosenzweig M. Incidence of preventable postoperative readmissions following pancreaticoduodenectomy: implications for patient education. Oncol Nurs Forum, 2012,39(4): 408-412.
[20] 王新颖,牛程麟,黄迎春, 等 . 单中心家庭肠内营养支持应用情况分析 . 肠外与肠内营养,2011,18(04):200-202, 206.
[21] Yu K, Zhou XR, He SL. A multicenter study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer. Eur J Clin Nutr, 2013, 67(7): 732-737.
[22] 明 军, 徐克强, 袁友强 . 家庭肠内营养应用于胃癌晚期患者中的效果 . 实用癌症杂志, 2015, 30(8): 1221-1223, 1226.
[23] 周飞燕, 许 勤, 陈 丽, 等 . 胃癌术后患者早期肠内营养达标状况及其影响因素研究 . 护理学杂志, 2012,27(6): 76-78.
[24] 袁 玲, 郭苗苗, 许 萍, 等 . 胃肠肿瘤术后化疗患者的营养风险状况及对化疗不良反应的影响 .中华护理杂志, 2011, 46(1):75-77.
[25] 周 婉,许 勤, 言克莉, 等 . 消化道肿瘤化疗患者营养风险状况与生活质量及化疗不良反应的相关性分析 . 护理学报, 2015,22(9): 1-4.

相似文献/References:

[1]陈小玉,刘祖平,白 鍊,等.结直肠癌病人根治术后家庭肠内营养支持的可行性及效果分析[J].肠外与肠内营养杂志,2019,(01):40.[doi:10.16151/j.1007-810x.2019.01.015]
 CHEN Xiao-yu,LIU Zu-ping,BAI Lian,et al.Feasibility and effectiveness analysis of home enteral nutrition support in patients with colorectal cancer after radical surgery[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):40.[doi:10.16151/j.1007-810x.2019.01.015]
[2]刘思彤,黄迎春,叶向红,等.家庭肠内营养管理在胃肠道疾病营养不良病人中的效果观察[J].肠外与肠内营养杂志,2020,(01):42.[doi:DOI : 10.16151/j.1007-810x.2020.01.010]
 LIU Si-tong,HUANG Ying-chun,YE Xiang-hong,et al.The effect of Home enteral nutrition in malnutrition patients with gastronintestinal diseases[J].PARENTERAL & ENTERAL NUTRITION,2020,(04):42.[doi:DOI : 10.16151/j.1007-810x.2020.01.010]
[3]冯筱青,白 倩,杜珊珊,等.家庭肠内营养对老年髋部骨折病人术后人体成分的影响[J].肠外与肠内营养杂志,2021,(03):135.[doi:10.16151/j.1007-810x.2021.03.002]
 FENG Xiao-qing,BAI Qian,DU Shan-shan,et al.Effects of family enteral nutrition on body composition of postoperative elderly patients with hip fracture[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):135.[doi:10.16151/j.1007-810x.2021.03.002]
[4]傅晨晨,黄迎春,叶向红,等.江苏省医护人员对炎症性肠病病人家庭肠内 营养管理的现状调查[J].肠外与肠内营养杂志,2022,(01):46.[doi:DOI : 10.16151/j.1007-810x.2022.01.009]
 FU Chen-chen,HUANG Ying-chun,YE Xiang-hong,et al.Investigation on the current status of the management of home enteral nutrition in patients with inflammatory bowel diseases by medical staff in Jiangsu Province[J].PARENTERAL & ENTERAL NUTRITION,2022,(04):46.[doi:DOI : 10.16151/j.1007-810x.2022.01.009]
[5]蔚 田,于健春.家庭肠内营养的卫生经济学评价研究进展[J].肠外与肠内营养杂志,2023,(01):51.[doi:DOI : 10.16151/j.1007-810x.2023.01.012]
 YU Tian,YU Jian-chun.Research progress on health economics evaluation of home enteralnutrition[J].PARENTERAL & ENTERAL NUTRITION,2023,(04):51.[doi:DOI : 10.16151/j.1007-810x.2023.01.012]

备注/Memo

备注/Memo:
基金项目 :2013上海交通大学医学院护理科研基金项目(jyh1302) 作者简介 :张 婷,主管护师,护理硕士研究生,研究方向为慢病护理。E-mail:rollin_zhangting@126.com
更新日期/Last Update: 1900-01-01