Nursing Experience of Early Application of Nasoenteric Tube for Enteral Nutrition in Critically Ill ICU Patients

Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction.

Validation of nutritional risk index method against patientgenerated subjective global assessment in screening malnutrition in colorectal cancer patients

Objective：To validate malnutrition screening tool of nutrition risk index （NRI） against patent-generated subjective global assessment （PG-SGA） as a gold standard tool in colorectal cancer patients before radiotherapy.Methods：Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA （gold standard method） and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results：The findings of PG-SGA and NRI showed that 52％ and 45％ of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66％ and a specificity of 60％ against PG-SGA.The positive predictive value was 64％ and the negative predicative value was 62％.The agreement between NRI and PG-SGA was statistically insignificant （kappa =0.267; P＞0.05）.Conclusions：The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.

The Values of the Prognostic Nutrition Index and the Patient Generated-Subjective Global Assessment during the Nutritional Assessment of Patients with Gastrointestinal Tumors

Objective To compare the value and consistency among the Patient Generated-Subjective Global Assessment(PG-SGA)and the Prognostic Nutrition Index(PNI)for assessing nutritional status in gastrointestinal tumor patients.Methods 251 patients from gastric cancer surgical ward from January 2019 to January 2020 were recruited through convenience sampling in this respective study.Nutritional screening and assessment were conducted for 251 gastrointestinal tumor patients using the nutritional risk screening 2002(NRS 2002)PG-SGA,and the PNI.PNI was calculated using the serum albumin level and the total lymphocyte count obtained from the patients’routine laboratory examination when they were admitted to the hospital.The receiver operating characteristic(ROC)of the PG SGA and the PNI were plotted with the NRS 2002 used as the gold standard,and the diagnostic value of the PG-SGA and PNI was reflected by the area under the curve(AUC),sensitivity,specificity and Youden index.We then determined the optimal cut-off for the PNI and tested the consistency of the PG-SGA and PNI.Results The optimal cut-off point for the PNI was calculated to be 50.78.The AUC of the PG-SGA was 0.908(95%CI 0.871-0.944).The sensitivity was 89.9%,specificity was 76.2%and the Youden index was 0.661.The AUC of the PNI was 0.594(95%CI 0.516-0.572).The sensitivity was 73.8%,specificity was 44.3%and the Youden index was 0.181.In the consistency test,the kappa value was 0.838(P<0.001).Conclusion The PNI is of limited value for assessing malnutrition,although it did have good consistency with the PG-SGA.The combination of the PNI and PG-SGA can be used for diagnosing assessing malnutrition in clinical practice.

Comparison of Four Tools Used for Nutritional Screening and Assessment in Cancer Patients:An Prospective Observational Study in China

The purpose of this study was to investigate and compare the efficacy of four screening tools commonly used to evaluate the nutritional status of cancer patients.A total of 173 patients(average age 50.7±12.9,89 males,84 females)with different pathology at admission were assessed using four nutritional screening tools,including the Body Mass Index(BMI),the Nutritional Risk Index(NRI),Patient-Generated Subjective Global Assessment(PG-SGA),and the Nutrition Risk Screening 2002(NRS 2002).The prevalence of malnourished/at high nutritional risk classified by the BMI,NRI,PG-SGA,and NRS 2002 were 12.7%,32.4%,65.3%,and 20.8%,respectively.Using the PG-SGA as a gold standard,the specificity and positive predictive value of the BMI and NRS 2002 were both 100%.The NRS 2002(K=0.245,P<0.001)and NRI(K=0.301,P<0.001)were found to be in poor agreement with the PG-SGA.The results for the BMI showed a moderate agreement(K=0.713,P<0.001)with the NRS 2002.There was a high prevalence of malnutrition in cancer patients,especially when assessed by the PG-SGA,which was superior to the BMI,NRI,and NRS 2002 in this study.The NRS 2002 may be used to screen for malnutrition and the risk of malnutrition in cancer patients before the implementation of the PG-SGA.

Modified B-ultrasound method for measurement of antral section only to assess gastric function and guide enteral nutrition in critically ill patients

AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patients. METHODS First,30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically. In addition,64 critically ill patients were selected,and the modified B-ultrasound method and the gastric juice withdrawal method were applied to guide the implementation of EN. Daily caloric value,the time required to achieve complete EN,ICU stay,hospitalization time,and serum prealbumin and albumin levels were recorded and compared between the two groups. Kaplan-Meier survival curve was used to compare the complications of EN between the two groups. RESULTS In healthy subjects,there was a good correlation among gastric emptying time,antral contraction frequency andantral motility index between the two groups(r = 0.57,0.61 and 0.54,respectively). The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group,in which patients had shorter ICU stay and hospitalization time and higher levels of serum prealbumin and albumin. The Kaplan-Meier survival analysis revealed that the improved B-ultrasound method was associated with significantly fewer EN complications(P = 0.031).CONCLUSION The modified B-ultrasound method can provide a good real-time assessment of gastric function and has a better effect than the traditional method in guiding EN in critically ill patients.

Evaluating the Nutritional Status of Oncology Patients and Its Association with Quality of Life

Objective The primary aim of the study was to compare two nutritional status evaluation tools： the Patient-Generated Subjective Global Assessment（PG-SGA） and Nutritional Risk Screening（NRS-2002）. Using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30（EORTC QLQ-C30）, the second aim was to provide constructive advice regarding the quality of life of patients with malignancy. Methods This study enrolled 312 oncology patients and assessed their nutritional status and quality of life using the PG-SGA, NRS-2002, and EORTC QLQ-C30. Results The data indicate that 6% of the cancer patients were well nourished. The SGA-A had a higher sensitivity（93.73%） but a poorer specificity（2.30%） than the NRS-2002（69.30% and 25.00%, respectively） after comparison with albumin. There was a low negative correlation and a high similarity between the PG-SGA and NRS-2002 for evaluating nutritional status, and there was a significant difference in the median PG-SGA scores for each of the SGA classifications（P 〈 0.001）. The SGA-C group showed the highest PG-SGA scores and lowest body mass index. The majority of the target population received 2 points for each item in our 11-item questionnaire from the EORTC QLQ-C30. Conclusion The data indicate that the PG-SGA is more useful and suitable for evaluating nutritional status than the NRS-2002. Additionally, early nutrition monitoring can prevent malnutrition and improve the quality of life of cancer patients.

Soluble Fiber Improves Management of Diarrhea in Elderly Patients Receiving Enteral Nutrition

Dietary fiber is a non-digestible carbohydrate providing beneficial effects for bowel health. The aim of this study was to evaluate the clinical effects of fiber supplementation in enteral feeding on elderly patients suffering from diarrhea. This study was conducted in 15 patients (7 men and 8 women, 79.0 ± 7.5 years) who had loose stools or diarrhea during enteral nutrition. The enteral formula was supplemented with soluble dietary fiber (5.2 g/day) for 3 weeks, which was then discontinued for 1 week to confirm its effects. The effects of soluble dietary fiber on stool frequency, the Bristol Stool Form Scale (which is designed to measure stool consistency), plasma diamine oxidase (DAO) activity, and concentrations of plasma short-chain fatty acids (SCFA) were evaluated. After supplementation with soluble dietary fiber, there were no significant differences in stool frequency but there was a significant improvement in stool consistency (P < 0.05). Furthermore, ingestion of soluble dietary fiber resulted in increased plasma DAO activity and significantly increased levels of plasma SCFA (P < 0.05). Supplementation with soluble dietary fiber may be beneficial for improving stool consistency in patients suffering from diarrhea during enteral nutrition. A further controlled trial is warranted to examine the preventive effects of soluble dietary fiber in patients suffering from diarrhea.

Prescription and Delivery of Enteral Nutrition for ICU Patients: A Case Study of a Hospital in the Interior of Brazil

Background: The objective of the present study was to evaluate during one year the total delivery of volume, calories, and proteins and compare them with the total prescribed to ICU patients using ENT (Enteral Nutrition Therapy) exclusively. Methods: Data on the prescribed or infused volume, calories, and protein, as well as their respective needs for each individual, were collected. Anthropometric parameters and age data were also collected from the medical records of 41 patients admitted to the intensive care unit. Results: Prescribed versus infused enteral diet volume was presented in 5 weeks which corresponds to the maximum duration of ICU treatment. Regarding sampling, the majority corresponded to elderly people (>64 years old) and males (63.4%). The total average prescribed was 719.2 mL of enteral diet on an average of 649.7 mL delivered. In addition, there was no significant difference between the prescribed and delivered volume, caloric value, and protein content of the diet only in the last week of hospitalization, which corresponded to the range of 29 - 36 days. Several factors make it difficult to reach the patient’s caloric and protein recommendations. Most of the reasons are not recorded, corresponding to 57.1%, indicating the difficulty of assessing the inadequacy of the prescribed and delivered volume. Conclusion: To our knowledge, this is the first time that a prescription vs. delivery assessment has been carried out for patients in the Brazilian Midwest. In addition, although our research is a difficulty reported worldwide (in most hospitals), we also provide opportunities for how the problem was solved in our case, which may contribute to other cases.

Development of a prediction model for enteral feeding intolerance in intensive care unit patients:A prospective cohort study

BACKGROUND Enteral nutrition(EN)is essential for critically ill patients.However,some patients will have enteral feeding intolerance(EFI)in the process of EN.AIM To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care unit.METHODS A prospective cohort study was performed.The enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were recorded.The baseline data and influencing factors were compared.Logistic regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal validation.RESULTS The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with EFI.After the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were identified.In the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.

Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

High Risk of Malnutrition in Uyghur Patients with Cancer in China

Background Patients with advanced cancer often present with malnutrition.Globally,minority populations frequently suffer from higher rates of malnutrition than the majority group.It was unknown whether the nutritional status of cancer patients is different between ethicality groups(i.e.Uyghur and Han)in China.Methods A total of 251 Uyghur cancer patients were enrolled from the Xinjiang Kashgar First People's Hospital in the INSCOC Program.The Han patients were 1∶1 matched to Uyghur patients by age,gender and type of cancer from 72 hospitals around China in INSCOC Program.The nutritional risk and nutritional status were assessed using the Nutrition Risk Screening 2002(NRS 2002)and Patient-Generated Subjective Global Assessment(PG-SGA),respectively.Then,the functional status of cancer patients was determined based on the Karnofsky Performance Status(KPS).Results The incidence of an abnormal NRS-2002(≥3),PG-SGA(≥4),and KPS(≤70)was significantly different(86.1%vs 59.0%,70.5%vs 27.5%,and 18.7%vs 4.0%,respectively P<0.05).The abnormal rate of laboratory indicators in Uyghur cancer patients was significantly higher than that in Han cancer patients,including total protein,albumin,serum total bilirubin,direct bilirubin,HDL-C,white blood cell,lymphocyte,red blood cell,and platelet(all P<0.05).The abnormal rates of TSF,HGS and CC were significantly higher than that of Han nationality patients(17.5%vs 9.7%,39.6%vs 19.6%,29.1%vs 15.2%,P<0.001).The nutritional support rate of Uyghur patients was lower than that of Han patients(0%vs 16.3%).After adjusting for potential risk factors,malnutrition was associated with gender(female,OR=0.35,95%CI=0.13-0.92,P=0.034),age(>60 years,OR=5.32,95%CI=1.46-19.41,P=0.011),cancer type(gastroesophageal tumor,OR=33.62,95%CI=3.42-330.67,P=0.003),and treatment methods(received radical tumor resection,OR=5.78,95%CI=1.45-23.08,P=0.008;received radiotherapy or chemotherapy:OR=7.69,95%CI=2.27-26.04,P<0.001).Conclusions The nutritional status of Uyghur cancer patients is worse than that of Han patients and the Uyghur patients with poor nutritional status lack the necessary nutritional support.

Perioperative nutrition optimization:a review of the current literature

Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to search prominent databases,including PubMed and Web of Science,using carefully selected keywords.Following meticulous screening,the inclusion of high-quality studies was prioritized,and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization.Results:The main contents include preoperative nutritional risk screening and assessment,nutritional support pathway,immune enhancing nutrition,preoperative and postoperative nutritional management,as well as personalized nutrition optimization strategies for specific populations(such as children,bariatric surgery patients,and cancer patients).Conclusions:In clinical practice,the importance of perioperative nutrition should be emphasized,and personalized nutrition management plans should be developed based on the characteristics and needs of patients.Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients.

Nutrition management in acute pancreatitis: Clinical practice consideration

Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees of inflammation and disease severity,ranging from self-limiting mild AP to devastating and fatal severe AP.Many factors contribute to malnutrition in AP,especially abnormal metabolism and catabolism related to inflammation.The concept of“pancreatic rest”is not evidence-based.There is however,emerging evidence that supports the use of oral or enteral nutrition to improve nutrition status and to reduce local and systemic inflammation,complications,and death.In mild disease,patients are generally able to initiate solid oral diet and do not require specialized nutrition care such as enteral or parenteral nutrition.In contrast,nutrition interventions are imperative in moderately severe and severe AP.The current article aims to review the latest evidence and suggest practical nutrition interventions in patients with AP,including nutrition requirements,routes of nutrition treatment,types of formula,and the role of nutritional supplements,such as glutamine,probiotics,omega-3 fatty acids,and antioxidants.

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury:A cross-sectional survey

This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury(STBI)in China and analysis the differences and their causes.Methods A cross-sectional survey was conducted.From December 2019 to January 2020,ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI.The questionnaire included two parts:the general information of participants(10 items)and application of preventive measures for feeding intolerance in STBI patients(18 items).Results Totally 996 nurses and physicians completed the questionnaire.Among various methods,gastrointestinal symptoms(85.0%)and injury severity(71.4%)were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients,respectively.Initiating enteral nutrition(EN)within 24–48 h(61.5%),nasogastric tubes(91.2%),30°–45°of head-of-bed elevation(89.5%),continuous feeding by pump(72.9%),EN solution temperature of 38–40°C(65.5%),<500 ml initial volume of EN solution(50.0%),monitoring gastric residual volume with a syringe(93.7%),and assessing gastric residual volume every 4 h(51.5%)were mostly applied for EN delivery among STBI patients.Prokinetic agents(73.3%),enema(73.6%),probiotics(79.0%),antacid agents(84.1%),and non-nutritional preparations as initial EN formula(65.6%)were commonly used for preventing feeding intolerance among STBI patients.Conclusions The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance.However,some effective new technologies and methods have not been timely applied in clinical practice.We suggest that managers,researchers,clinicians,nurses,and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.

Misconceptions and truths for feeding patients in the intensive care unit: Case studies with practical nursing solutions

The Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient published in May 2009 (joint guidelines between the Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) have advanced our clinical practice for the nutritional management of critically ill patients. In the current article, we will review how to implement these guidelines using a case study model. Two mechanically ventilated and tube fed patients are discussed, one with pneumonia and the second with severe acute pancreatitis. We address the questions of the feeding timing, method of administration, and management of its complications for these two patients.

1例小肠双腔造瘘合并急性胰腺炎超高龄患者的营养支持护理

报道1例小肠双腔造瘘合并急性胰腺炎超高龄患者的营养支持护理经验。护理要点包括以营养状况评估、个体化的营养支持方案、使用肠内营养耐受性评估管理工具和中医适宜技术为主的营养支持护理,辅以功能锻炼和小肠双腔造口护理。患者急性胰腺炎期经过积极治疗,早期鼻空肠营养,及时调整营养支持方案为改良式(轻断食)喂养,现已恢复正常鼻饲量,营养状态良好。目前,小肠双腔造瘘合并急性胰腺炎的营养支持护理的相关报道较少,现将该患者的护理过程整理报道,以期为更多患者提供借鉴。

临床医生营养风险筛查认知现状调查

目的:调查临床医生营养风险筛查的现状,为进一步规范住院患者营养管理提供参考依据。方法:采用便利抽样法,应用成人营养筛查认知度调查问卷对山西某三级甲等医院的临床医生进行调查。结果:244名医生中,233名(95.5%)医生知晓成人营养筛查表,89名(36.5%)医生能够亲自全程根据成人营养风险筛查表筛查患者,55名(22.5%)医生知晓营养风险筛查分值,160名(65.6%)医生知晓营养风险筛查评估频次,110名(45.1%)医生非常重视住院患者营养状况,44名(18.0%)医生通过培训获取营养知识。结论:临床医生对营养风险筛查认识不足,应开展系统规范的培训,完善临床营养专业队伍建设。

3种营养筛查工具在骨与软组织肿瘤患者营养不良风险评估中的临床价值

目的:调查骨与软组织肿瘤患者营养不良风险的发生情况,探索营养风险筛查2002(NRS2002)、通用筛查工具(MUST)、患者主观整体评估简表(PG-SGASF)等3种营养筛查工具在骨与软组织肿瘤患者营养不良风险评估中的临床价值。方法:对山西省肿瘤医院骨与软组织科2023年8月—2024年5月的所有入院成年患者进行问卷调查,调查内容包括:患者一般情况(年龄、性别、身高、体重);患者体重在近2周、1个月、2个月、3个月、6个月的变化情况;饮食改变情况以及影响饮食的原因等。整理完成NRS2002、MUST、PG-SGASF得分。结合患者临床资料疾病诊断、治疗情况进行统计分析。率的比较采用卡方检验,定量资料两组比较采用Mann-Whitney检验,多组比较采用Kruskal-WallisH检验,绘制韦恩图、ROC曲线。结果:合格问卷633份,男性327例、女性306例,平均年龄(54.41±14.35)岁。骨与软组织肿瘤患者营养不良风险在14%~22%之间,恶性肿瘤患者营养不良风险发生率更高。3种筛查结果绘制韦恩图显示,NRS2002与MUST一致性更高。以NRS2002为基础绘制ROC曲线(曲线下面积:MUST:0.9287,PG-SGASF:0.596)。结论:骨与软组织肿瘤患者营养不良风险发生率较其他类型肿瘤患者偏低,但恶性度越高营养不良风险越大。NRS2002有一定的漏诊情况,MUST简易且全面,PG-SGASF更适合用于评估。

基于患者主观整体评估的个体化营养干预在胃癌根治术后辅助化疗患者中的应用效果

目的探讨基于患者主观整体评估(PG-SGA)的个体化营养干预在胃癌根治术后辅助化疗患者中的应用效果。方法根据干预方式的不同将108例胃癌根治术后辅助化疗患者分为对照组(n=48)和观察组(n=60),对照组患者接受常规干预,观察组患者在对照组患者的基础上接受基于PG-SGA的个体化营养干预,比较两组患者的营养指标[白蛋白(ALB)、前白蛋白(PAB)、总蛋白(TP)、预后营养指数(PNI)]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及满意情况。结果干预后,两组患者ALB、PAB、TP、PNI、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及EORTC QLQ-C30各维度评分均高于本组干预前,观察组患者ALB、PAB、TP、PNI、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、EORTC QLQ-C30各维度评分及总满意度均高于对照组,差异均有统计学意义(P﹤0.05)。结论基于PG-SGA的个体化营养干预应用于胃癌根治术后辅助化疗患者,可以改善患者的营养状态及免疫功能,提高患者的生活质量及满意度。

基于患者自评-主观全面评定量表的个性化营养干预在胃癌术后化疗患者中的应用效果

目的探讨基于患者自评-主观全面评定量表(PG-SGA)的个性化营养干预在胃癌术后化疗患者中的应用效果。方法根据干预方式的不同将132例胃癌术后化疗患者分为对照组(n=65)和观察组(n=67),对照组患者采取常规干预,观察组患者在对照组的基础上采取基于PG-SGA的个性化营养干预。比较两组患者的胃肠功能恢复指标、营养指标[血红蛋白(Hb)、白蛋白(ALB)、总蛋白(TP)]、免疫功能指标[免疫球蛋白(Ig)A、IgM、IgG、CD3^(+)、CD4^(+)、CD8^(+)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]以及不良反应发生情况。结果观察组患者腹胀改善时间、首次排气时间及肠鸣音恢复时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者Hb、ALB、TP水平均高于本组干预前,观察组患者Hb、ALB、TP水平均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者IgA、IgG、IgM、CD3^(+)、CD4^(+)水平均高于本组干预前,CD8^(+)水平均低于本组干预前,观察组患者IgA、IgG、IgM、CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者EORTC QLQ-C30各维度评分均高于本组干预前,观察组患者EORTC QLQ-C30各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的不良反应总发生率低于对照组(P﹤0.05)。结论基于PG-SGA的个性化营养干预应用于胃癌术后化疗患者,能够改善患者的营养状态及免疫功能,促进患者胃肠功能恢复,提高患者生活质量,降低不良反应发生率。