南京某三级医院2015至2019年间胃肠道恶性肿瘤病人营养风险和营养治疗现状调查分析

Nutritional risk and nutritional support among patients with gastrointestinal cancer from 2015-2019 in a tertiary hospital in Nanjing

目的:调查分析2015至2019年间南京江北人民医院胃肠道恶性肿瘤病人营养风险与营养治疗情况。方法:回顾性收集430例胃肠道恶性肿瘤病人的一般情况、营养风险发生率、营养治疗方式和种类等临床信息,并判断临床营养治疗的合理性。结果:430例胃肠道肿瘤病人入院24 h内,营养风险筛查2002量表评分结果显示营养风险总发生率为57.2%。存在营养风险病人中有58.9%接受营养支持治疗,而无营养风险病人中亦有46.2%接受了营养支持治疗。术后接受全肠外营养、全肠内营养、肠外联合肠内营养治疗的比例分别为39.8%、0.5%、59.8%。其中,胃癌病人术后肠内营养支持率常年高于90%,结直肠癌低于30%。5年间平均免疫营养支持率为45.6%,且比例呈逐年上升趋势。结论:胃肠道恶性肿瘤病人营养风险发生率高,临床中仍存在营养治疗不合理的问题,围手术期需加强营养支持的学习和规范化的推广。

Objective:To investigate the nutritional risk and nutritional support conditions of patients with gastrointestinal cancer from 2015~2019 in a tertiary hospital in Nanjing.Methods:The clinical information such as general conditions,nutritional risk incidence and nutritional support methods and types of 430 patients with gastrointestinal cancer were retrospectively collected.The rationality of clinical nutritional therapy was also evaluated.Results:The nutritional risk of all patients was evaluated based on nutrition risk screening 2002 within 24 hours of admission,and the results showed that the incidence of nutritional risk was 57.2%.There were 58.9%of patients with nutritional risk received nutrition therapy,while 46.0%of patients without nutritional risk also received nutrition therapy.The incidence of total parenteral nutrition,total enteral nutrition,and parenteral and enteral nutrition provided to patients during postoperative period was 39.8%,0.5%,and 59.8%.The incidence of postoperative enteral nutritional support among gastric cancer patients was always higher than 90%,while the colorectal cancer patients was lower than 30%.In addition,the incidence of immunonutrition support was 45.6%and it was increased year by year.Conclusion:Patients with gastrointestinal cancers have a high incidence of nutritional risk and the rationality of clinical nutrition therapy needs to be modified.