家居肿瘤患者的营养治疗专家共识

Expert consensus on nutritional therapy for home cancer patients

肿瘤患者更容易发生营养不良,且营养不良比例更高。住院治疗期间,医护人员可以根据患者的情况进行合理的营养治疗以改善患者的状况,但多数肿瘤患者更多的时间是在家中而不是在医院度过,因此,家居肿瘤患者的营养治疗同样重要。所有的家居肿瘤患者需要接受专业的医护人员或营养师进行营养风险筛查和评估,以决定是否需要进行家庭营养治疗。无法通过进食和口服营养补充满足家居肿瘤患者需求时,应考虑启动家庭肠内营养和/肠外营养的实施。家庭肠外营养需要建立肠外营养配制室,严格按照无菌操作技术及配制流程在专业人士的指导后进行肠外营养制剂的配制。脂肪乳剂可减少长期肠外营养治疗的炎性反应,改善患者的预后。长期接受家庭肠外营养治疗的患者应适量补充谷氨酰胺。

Cancer patients are more prone to malnutrition,and the proportion of malnutrition is higher.During hospitalization,medical staff can provide reasonable nutritional treatment based on the patient′s condition to improve their condition.However,most cancer patients spend more time at home rather than in the hospital.Therefore,nutritional treatment for home cancer patients is equally important.All home cancer patients need to undergo nutritional risk screening and assessment by professional healthcare professionals or nutritionists to determine whether home nutrition treatment is necessary.When it is not possible to meet the needs of home cancer patients through food and oral nutrition supplementation,the implementation of home enteral and/or parenteral nutrition should be considered.Home parenteral nutrition requires the establishment of a parenteral nutrition preparation room,strictly following sterile operating techniques and preparation processes,and preparing parenteral nutrition preparations under the guidance of professionals.Fat emulsion can reduce the inflammatory response of long-term parenteral nutrition treatment and improve the prognosis of patients.Patients who receive long-term home parenteral nutrition treatment should supplement with glutamine in moderation.