引用文本：陈颖, 彭利芬, 蒋满凤. 营养专科护士主导的围手术期全程营养管理对胃癌患者临床结局的影响[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(3):392-399.

作者：陈颖，彭利芬，蒋满凤

单位：中山大学附属第一医院胃肠外科二科，广东 广州 510080

Authors：Chen Ying, Peng Lifen, Jiang Manfeng

Unit：Unit 2, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

目的 探讨营养专科护士主导的围手术期全程营养管理对胃癌患者营养状况及临床结局的影响。方法 采用便利抽样法及研究对象单盲的方法，将2022年5月至2024年2月就诊于中山大学附属第一医院胃肠外科符合纳入排除标准的胃癌患者分为试验组和对照组，每组各48例。对照组实施常规营养管理，试验组实施由营养专科护士主导的营养评定、制定食谱、监测与反馈等全程营养管理。比较两组患者入院24 h内、手术当天、术后第4天、出院时、术后1个月时的营养风险筛查2002（nutritional risk screening 2002, NRS 2002）评分、患者主观整体评估（patient-generated subjective global assessment, PG-SGA）评分、体重、体重指数和营养相关实验室指标（血清白蛋白、前白蛋白、血红蛋白、总蛋白），并比较两组患者胃肠道不良反应发生率、胃肠道功能恢复时间、住院天数及住院费用。结果 试验组患者术后1个月NRS 2002评分、出院时及术后1个月PG-SGA评分均较对照组低（均P<0.05）。试验组患者出院时与入院时体重差值、术后1个月与入院时体重差值均较对照组小（均P<0.05）。试验组患者手术当天总蛋白、前白蛋白水平均较对照组高（均P<0.05），术后第4天及出院时血红蛋白、血清白蛋白、总蛋白、前白蛋白水平均较对照组高（均P<0.05）。试验组患者胃肠道不良反应总发生率、腹胀发生率均较对照组低（均P<0.05）。试验组患者术后肠鸣音恢复时间、术后首次排气时间和首次排便时间均较对照组早（均P<0.05）。试验组患者术后住院天数、住院总天数、住院费用均较对照组少（均P<0.05）。结论 营养专科护士主导的全程营养管理能促进胃癌患者营养状况及临床结局的改善。

关键词：营养专科护士；全程营养管理；胃癌；围手术期；临床结局

Abstract：

Objective To explore the effect of whole-course nutrition management led by nutrition nurse on nutriture and clinical outcome of perioperative patients with gastric cancer. Method Using convenience sampling and single-blind methods for the research subjects, patients with gastric cancer who met the inclusion and exclusion criteria and were treated in the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University from May 2022 to February 2024 were divided into the experimental group and the control group, with 48 cases in each group. The control group received routine nutrition management, while the experimental group received full-course nutrition management led by nutrition specialist nurses, including nutritional assessment, diet planning, monitoring, and feedback. The nutritional risk screening 2002 (NRS 2002) score, patient-generated subjective global assessment (PG-SGA) score, weight, body mass index, and nutrition-related laboratory indicators (serum albumin, prealbumin, hemoglobin, total protein) of the two groups were compared at 24 hours after admission, on the day of surgery, on the 4th day after surgery, at discharge, and one month after surgery. The incidence of gastrointestinal adverse reactions, recovery time of gastrointestinal function, length of hospital stay, and hospitalization costs were also compared between the two groups.  Result The NRS 2002 score of the experimental group one month after surgery, and the PG-SGA scores at discharge and one month after surgery were all lower than those of the control group (all P<0.05). The differences in weight between discharge and admission, and between one month after surgery and admission in the experimental group were smaller than those in the control group (all P<0.05). The levels of total protein and prealbumin of the experimental group on the day of surgery were higher than those of the control group (all P<0.05), and the levels of hemoglobin, serum albumin, total protein, and prealbumin of the experimental group on the 4th day after surgery and at discharge were all higher than those of the control group (all P<0.05). The total incidence of gastrointestinal adverse reactions and the incidence of abdominal distension in the experimental group were all lower than those in the control group (all P<0.05). The recovery time of bowel sounds, the time of first postoperative flatus, and the time of first postoperative defecation in the experimental group were all earlier than those in the control group (all P<0.05). The postoperative hospital stay, total hospital stay, and hospitalization costs of the experimental group were all less than those of the control group (all P<0.05). Conclusion The whole-course nutrition management led by nutrition nurse can improve the nutritional status and clinical outcome of gastric cancer patients.

Key words：Nutrition nurse; Whole-course nutrition management; Gastric cancer;  Perioperative period; Clinical outcome

注：网络优先发布