Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

Study on the Clinical Application of Nutritional Management Combined with Clinical Monitoring of Glycated Albumin in Diabetic Nephropathy Dialysis Patients

Objective:To explore the clinical application of nutritional management combined with clinical monitoring of glycated albumin(GA)in diabetic nephropathy(DN)dialysis patients.Methods:A total of 20 diabetic nephropathy dialysis patients admitted to the People’s Hospital of Guandu District from January 2022 to February 2023 were included in the study.They were randomly divided into a conventional group(n=10)and an observation group(n=10).The study evaluated the blood glucose control,nutritional status,dialysis efficacy,and quality of life scores of both groups.Results:Before the intervention,there were no significant differences in fasting plasma glucose(FPG),GA,serum albumin,body mass index(BMI),dialysis efficiency values,urea clearance rate,or quality-of-life scores between the two groups(P>0.05).After the intervention,the observation group showed significantly lower FPG and GA levels,higher serum albumin,dialysis efficiency values,urea clearance rate,and improved quality-of-life scores compared to the conventional group(P<0.05),with no difference in BMI(P>0.05).Conclusion:Nutritional management combined with clinical monitoring of glycated albumin has a significant effect on the clinical application of diabetic nephropathy dialysis patients.It can effectively improve patients’blood glucose control and nutritional status,reduce the risk of complications,and enhance the quality of life,demonstrating clinical value for broader application.

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.

Economic Cost of Community-Based Management of Severe Acute Malnutrition in a Rural District in Ghana

Background: The community based management of severe acute malnutrition (CMAM) was introduced in Ghana in 2008 to manage cases of severe acute malnutrition (SAM) recorded at the community level. This study estimated the economic cost of the CMAM programme for children under-five in the Agona west municipality of Ghana. Methods: A retrospective cross sectional study that used a cost analysis design was employed to estimate the economic cost of the programme from the societal perspective. Household cost data from caregivers were obtained using a semi-structured questionnaire. That of programme cost data was obtained from document reviews as well as the use of semi-structured questionnaires and subsequent discussions with key personnel of the Ghana Health Service, Food and Nutrition Technical Assistance and UNICEF. One and multi-way sensitivity analyses were conducted to test how sensitive the cost estimates are to certain variations in the cost profiles. Results: The economic household cost of CMAM was estimated as $1905.32 ($47.63 per household) of which 79% was attributed to direct cost while the remaining 21% made up indirect cost. Programme economic cost of CMAM was estimated as $27633.5 (96% recurrent and 4% capital), with refresher training constituting majority of the cost (34%). The constituents of the total economic cost of the programme, estimated as $32214.56 are programme cost (86%), household costs (6%) and community volunteer cost (8%). Therefore, the economic cost of treating one SAM case using the CMAM protocol was estimated as $805.36. Conclusion: Although CMAM has proven to be an effective tool for the management of SAM, its associated costs are quite enormous when coverage levels (geographic) are high yet small number of cases are detected and treated. Therefore, it is prudent to implement several cost saving strategies such as a reduction in the number of days spent on trainings in order to reduce these costs.

Community Based Management of Severe Acute Malnutrition: The MSF Experience from an Urban Slum Setting in Bangladesh

Background: Until recently, the experience on implementing community based management of acute malnutrition (CMAM) among children has been largely based in African settings. While the government in Bangladesh is yet to scale up CMAM approach, there is still paucity of knowledge on the experience of CMAM within the complex milieu of an urban slum context. In Kamrangirchar slum, Dhaka, Bangladesh, this paper describes a CMAM programme performance and outcomes run by Médecins Sans Frontières (MSF)/Doctors without Borders, in light to performance indicators set by MSF and the Sphere minimum standards. Methods: This was a descriptive retrospective study using routinely collected programme data of children admitted with severe acute malnutrition between May 2010 and November 2011. Kamrangirchar is an urban slum of a large migrant population in Dhaka, Bangladesh. Results: There was a total of 640 new admissions, of whom 333 (52%) were males. The median age was 18 months (Inter-quartile range (IQR) 12 - 41). 599 children had a reported nutritional outcome at discharge from ambulatory therapeutic feeding centre (ATFC), this included: cure rate of 69% with an average length of stay of 68.8 (SD ± 46.0) days and average weight gain of 3.8 g/kg/day (SD ± 2.7). The lost-to-follow-up rate was 18% and 5% reported to the programme that they will leave the slum and go back to their villages. These performance indicators did not meet the threshold level indicators set by MSF and Sphere standards. Conclusions: Our experience highlights the need for developing more adapted and contextualised indicators for assessing the performance of CMAM programmes in settings such as urban slums. Community engagement in the process of developing relevant standards is crucial. Nutrition humanitarian actors have a vital role to collaborate with local authorities to contextualize and refine these standards.

A Whole-Course and Multidisciplinary Nutrition Management Model for Breast Cancer: A Typical Case Report

Breast cancer patients face different nutritional problems at each stage. However, the nutrition of breast cancer patients has not been taken seriously. As a result, some patients cannot tolerate treatment due to poor nutrition, thus affecting the prognosis. This study aims to introduce a typical case to explore the whole-course (started at admission and ended 5 years after surgery) and Multidisciplinary Teams (MDTs) (comprising physician, primary nurse, case manager, nutrition liaison and nutrition specialist nurse) nutritional management mode of breast cancer patients. The patient successfully completed the scheduled treatment by implementing the whole-course and multidisciplinary nutrition management. The mode can prospectively and dynamically estimate the changes in patients’ nutritional status, and provide timely nutritional intervention to promote patient outcomes.

Preliminary study on nutritional diet management in the prevention and treatment of COVID-19 in China

Through the painstaking efforts,the situation of epidemic prevention and control is now developing in a positive direction.Nutritional Diet health management is an important part of health management.The main objective of nutritional diet health management is to improve the clinical outcomes,quality of life and cost-effectiveness ratio of patients with COVID-19 through standardized nutritional support,nutritional diet supplement and medical nutritional diet therapy,for the benefit of patients with COVID-19.

Diagnosis and Management of Obesity: A Joint Statement by Practicing Endocrinologists

Obesity is not always recognized as a primary disease, leading to shortage of insurance coverage, clear dispositions about therapeutic strategies, prevention programs and legislation. Worldwide, physicians face the challenge to design affordable and effective treatments against obesity, to improve patient health and wellbeing and reduce the burden on healthcare systems. While international guidelines for obesity management are available, straightforward recommendations applicable in developing countries are needed. In order to develop local consensus recommendations, a panel of endocrinologists with experience in overweight and obesity convened and provided opinions about obesity aetiology, diagnosis, and management, in a structured discussion. Opinions were then developed into recommendations. There was unanimous agreement on recognizing obesity as a disease, which could be diagnosed by any trained physician and best managed by endocrinologists or obesity-trained physicians. The panel reiterated that lifestyle and behaviour changes remain the cornerstone of treatment;underscoring, however, the need for pharmacotherapy or bariatric surgery in some cases. They also identified stakeholders in the fight against obesity (ministries, third-party payers, healthcare providers and others). The establishment of an obesity registry was encouraged, which will pave the way for enhanced obesity research and prevention programs. These recommendations, endorsed by the World Obesity Federation, would be of interest to clinicians worldwide. .

A Preliminary Assessment of the Effect of Urban Waste Pollution in the Korle Lagoon Area of Accra, Ghana, on Nutrition and Growth of Maize (Zea mays L.) Plants

Disposal of domestic and industrial waste into the Odaw River and Korle Lagoon in Accra, Ghana, has led to pollution of the lagoon and surrounding soils. This study compared the elemental concentrations of heavy metals (lead and zinc) and essential plant macronutrients (nitrogen, phosphorus and potassium) in soils from the Korle Lagoon Area to those in baseline soils from the University of Ghana Agricultural Farm (UG Farm), also in Accra. A comparative pot experiment, using maize (Zea mays L.) as test plant, was conducted to assess the effect of each soil type on plant growth. Soil samples from the Korle Lagoon Area were significantly higher (P < 0.001) in lead (Pb), zinc (Zn), nitrogen (N) and potassium (K) concentrations than samples from the UG Farm. Mean plant height and mean leaf width of maize plants harvested 7 weeks after planting (WAP) were both significantly higher (P < 0.003) for samples from the Korle Lagoon Area soil compared to those from the UG Farm soil. Higher accumulation of Zn (448.3 ± 45.5) in maize shoot within 3 weeks of planting in the Korle Lagoon Area soil had phytotoxic effects on growth, resulting in shoot growth inhibition and reduced uptake of P and K in 11-week-old plants. The findings indicate that though nutrient enrichment due to sewage disposal into the lagoon may increase crop production, the nutritional quality of the crop produced could be compromised by heavy metal accumulation in the soil and subsequent uptake by the plant.

Current strategies for reproductive management of gilts and sows in North America

Many advances in genetic selection, nutrition, housing and disease control have been incorporated into modern pork production since the 1950s resulting in highly prolific females and practices and technologies, which significantly increased efficiency of reproduction in the breeding herd. The objective of this manuscript is to review the literature and current industry practices employed for reproductive management. In particular the authors focus on assisted reproduction technologies and their application for enhanced productivity. Modern maternal line genotypes have lower appetites and exceptional lean growth potential compared to females of 20 yr ago. Thus, nutrient requirements and management techniques and technologies, which affect gilt development and sow longevity, require continuous updating. Failure to detect estrus accurately has the greatest impact on farrowing rate and litter size. Yet, even accurate estrus detection will not compensate for the variability in the interval between onset of estrus and actual time of ovulation. However, administration of GnRH analogs in weaned sows and in gilts after withdrawal of altrenogest do overcome this variability and thereby synchronize ovulation, which makes fixed-time AI practical. Seasonal infertility, mediated by temperature and photoperiod, is a persistent problem. Training workers in the art of stockmanship is of increasing importance as consumers become more interested in humane animal care. Altrenogest, is used to synchronize the estrous cycle of gilts, to prolong gestation for 2-3 d to synchronize farrowing and to postpone post-weaning estrus. P.G. 600~ is used for induction of estrus in pre-pubertal gilts and as a treatment to overcome seasonal anestrous. Sperm cell numbers/dose of semen is significantly less for post cervical AI than for cervical AI. Real-time ultrasonography is used to determine pregnancy during wk 3-5. PGF2a effectively induces farrowing when administered within two d of normal gestation length. Ovulation synchronization, single fixed-time AI and induced parturition may lead to farrowing synchronization, which facilitates supervision and reduces stillbirths and piglet mortality. Attendance and assistance at farrowing is important especially to ensure adequate colostrum consumption by piglets immediately after birth. New performance terminologies are presented.

Early phase of acute pancreatitis: Assessment and management

Acute pancreatitis(AP) is a potentially life-threatening disease with a wide spectrum of severity. The overall mortality of AP is approximately 5%. According to the revised Atlanta classification system, AP can be classified as mild, moderate, or severe. Severe AP often takes a clinical course with two phases, an early and a late phase, which should both be considered separately. In this review article, we first discuss general aspects of AP, including incidence, pathophysiology, etiology, and grading of severity, then focus on the assessment of patients with suspected AP, including diagnosis and risk stratification, followed by the management of AP during the early phase, with special emphasis on fluid therapy, pain management, nutrition, and antibiotic prophylaxis.

Nutritional impact of mycotoxins in food animal production and strategies for mitigation

Mycotoxins are toxic secondary metabolites produced by filamentous fungi that are commonly detected as natural contaminants in agricultural commodities worldwide.Mycotoxin exposure can lead to mycotoxicosis in both animals and humans when found in animal feeds and food products,and at lower concentrations can affect animal performance by disrupting nutrient digestion,absorption,metabolism,and animal physiology.Thus,mycotoxin contamination of animal feeds represents a significant issue to the livestock industry and is a health threat to food animals.Since prevention of mycotoxin formation is difficult to undertake to avoid contamination,mitigation strategies are needed.This review explores how the mycotoxins aflatoxins,deoxynivalenol,zearalenone,fumonisins and ochratoxin A impose nutritional and metabolic effects on food animals and summarizes mitigation strategies to reduce the risk of mycotoxicity.

Analysis on Nutritional Risk Screening and Influencing Factors of Hospitalized Patients in Central Urban Area

Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient＇s poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002（NRS2002） for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis（P〈0.05）, to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk（P〈0.05）. Having considered the above-mentioned factors as independent variables and nutritional risk（Y=1, N=0） as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

Classification of plant functional types based on the nutrition traits： a case study on alpine meadow community in the Zoigê Plateau

The ecological concept of Plant Functional Types（PFTs）, which refers to the assemblage of plants with certain functional traits, has been introduced for the study of plant responses to the environment change and human disturbance. Taking the alpine meadow community in the Zoigê Plateau as a study case, this paper classified PFTs in terms of plant nutrition traits. The sequential results are as follows.（1） The main herbages in the Zoigê Plateau included 16 species in 5 families. Among the five families, Cyperaceae vegetation accounted for 81.37%of herbage area in total, while the remaining 4families occupied less than 20%. As for the species,Kobresia setchwanensis Hand.-Maizz. was dominant,accounting for 48.74% of the total area; while the remaining 51.26% was comprised of Polygonum viviparum L., Anaphalis fiavescens Hand.-Mazz.,Stipa aliena Keng and other species.（2） By using the Principal Component Analysis（PCA）, the assessment of herbages nutrition was carried out based on the comprehensive multi-index evaluation model.Polygonum viviparum L. had the highest nutritional value score（1.43）, and Stipa aliena Keng had the lowest（-1.40）. Nutritional value of herbage species had a significantly positive correlation with altitude（P＆lt;0.01） in the Zoigê Plateau.（3） Based on the nutritional values, herbages in the Zoigê Plateau could be grouped into 3 nutrition PFTs（high, medium and low） by using the Natural Breaks（Jenks） method.

Effect of Silicon and Nitrogen Nutrition on Pest and Disease Intensity in Rice

Nutrition management is the most important for high yield production but it may affect the response of rice plants to pest and diseases due to the change of microclimate under rice plant canopy. The knowledge of nutrition management and its relation with pest and diseases are basis for setting up a high yield production system. Most of the pest and disease control procedures used by farmers can be considered as soil fertility management and these nutrition practices can have impact on the physiological susceptibility of crop plants to pest and diseases by affecting the plant resistance. Silicon content of plants is particularly effective against pest and diseases in rice and certain rice genotypes are more efficient accumulators of silicon, thus making them more resistant. In the absence of natural heritable resistance in rice varieties, resistance could be induced by altemate strategies to suppress certain pest and pathogens. Hence experiments were carried out in two stages during kharif 2010 and 2011 to assess the concentration of silicon in the index leaves of rice plant utilizing 133 varieties in four locations. The silica content of promising varieties ranged from 1.50% to 3.20%, 1.60% to 3.15%, 1.49% to 3.20% and 1.55% to 3.06% with a mean values of 2.50%, 2.48%, 2.51% and 2.43% at Jagtial, Warangal, Rajendranagar and Rudrur centres of Telangana region and not much variation in mean silica content in index leaves at different places. The overall yield from four locations ranged from 2,653 kg/ha to 6,860 kg/ha with a mean of 5,624 kg/ha. The yields recorded at Jagtial, Warangal, Rajendranagar and Rudrur centres ranged from 2,886 to 7,198, 2,653 to 6,831, 2,653 to 6,860 and 4,399 to 5,950 kg/ha, respectively. The lowest mean yield 5,069 kg/ha was noticed at Rudrur and the highest yield 5,940 kg/ha was found at Warangal. The variations in yields might be due to genotypic variations and also due to variations in climatic conditions of different locations.

Discipline of Nutritional Oncology:Principle,Theory,Practice and Perspectives

Cancer poses a major health problem worldwide.There is a trend of increasing incidence and mortality of several types of cancer in China.Although major breakthroughs have been made in cancer treatment,including advances in surgical procedures,radiotherapy,chemotherapy,targeted therapy,and immunotherapy,the prognosis of cancer patients is still not optimal.It is widely accepted that malnutrition is commonly seen in cancer patients and that nutritional intervention can improve such patients’overall survival status by supplementing deficient nutrients,regulating abnormal metabolism,improving immune function,and modulating tumor growth.Thus,fighting malnutrition can improve patients’quality of life and survival.This review article provides a summary of development of nutritional oncology as an independent clinical discipline,recent advances,and problems and challenges faced by health care professionals in managing malnutrition among cancer patients.We propose several strategies and approaches to establish nutritional intervention programs in hospitals,including education,clinical nutritional diagnosis and treatment,which may meet the nutrition and treatment goals for patients with cancer in China.We hope that with national-wide development and implementation of nutritional intervention programs,more cancer patient in China will benefit from such endeavors,making nutritional oncology the frontier of cancer treatment not only in China,but also in whole world.

The Importance of Nutrition during Treatment for Oesophageal Cancer—The Patient’s Perspective

Background and Objectives: Nutritional issues are prevalent in patients with oesophageal cancer (OC) across all aspects of treatment, including chemoradiotherapy (CRT) and surgery. There are limited studies investigating nutritional issues faced by people undergoing neoadjuvant or definitive CRT from the patient’s perspective. This study aimed to explore the importance that people with OC place upon nutrition during their treatment which included neoadjuvant or definitive CRT, explore the nutritional issues faced in this patient group and identify areas for improvement of dietetic services. Methods and Study Design: Nine people who had undergone curative treatment for OC in the previous 2 - 25 months participated in semi-structured phone interviews. Interviews were tape-recorded and transcribed verbatim and analysed using an inductive thematic analysis approach. Results: Interviews revealed severe difficulties in food consumption during and following CRT and a period of struggling to adjust eating habits post oesophagectomy. There was significant difficulty in following nutrition advice and, despite participants expressing the importance of nutrition;this was not reflected in attitudes towards weight loss. The medical team significantly influenced the perceptions of some participants in regards to their weight loss. Conclusions: Implications for clinical practice include the need for dietetic services before, during and after treatment for OC, irrespective of treatment type. Patient education regarding detrimental effects of rapid weight loss and effects on body composition is crucial, and this should be consistent from all members of the healthcare team.

Solanum lycopersicum: Novelties for Climate Factors and Its Agronomic Management for High Yields

The intensive production of vegetables such as tomatoes depends on various strategies to achieve high yields.Purpose of this manuscript is to provide scientific and technological strategies for the intensive production of tomato or other vegetables in mega-production factories. However, with the advancement of knowledge, new improvements in the strategies will be incorporated. We have carried out research related to growth and yield variables in S. Lycopersicum. From this research we have worked on the intensive production of this noble vegetable at an industrial level. The results obtained are improvements in the production system. The improvements include the selection of the appropriate variety, germination and development of seedlings in a certified nursery. Trans-plantation in soil or hydroponics. The conditions of nutrient applications from the irrigation head system. The ventilation system and monitoring of climatic factors both day and night (temperature and relative humidity). Monitoring of macro- and micronutrients in the plant system, including Ca, K, Fe, and Zn. Soil fertility analyzes should include: primary and secondary macronutrients (ppm), organic matter (OM), EC, pH, bulk density (BD), and cation exchange capacity (CEC). The nutritional diagnosis to confirm ranges of sufficiency. As a tool in plant nutrition programs, foliar application can include biostimulants and growth regulators. The foregoing can be considered strategies for the integral management of the tomato crop.

Effect of Healthcare Failure Mode and Effect Analysis on Reducing Error Risk of Neonatal Parenteral Nutrition Solution Dispensing

[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.

生态系统理论指导下的营养管理对急性淋巴细胞白血病化疗患儿营养状态的影响

目的:分析生态系统理论指导下的营养管理对急性淋巴细胞白血病(ALL)化疗患儿营养状态的影响。方法:选取2021年1月至2021年12月郑州大学第一附属医院收治的86例ALL患儿,采用群随机的方法分为对照组和观察组,每组各43例。对照组采取常规的营养管理,观察组采用生态系统理论指导下的营养管理。干预前后采用全自动生化仪检测血清白蛋白(ALB)、前白蛋白(PA)和转铁蛋白(TFN)水平,测量患儿上臂围、三角肌皮褶厚度,采用Piper疲乏量表评估癌因性疲乏程度。记录患儿干预期间不良反应发生情况。结果:干预后观察组血清ALB、PA、TFN、上臂围较干预前的下降幅度小于对照组(P<0.05),躯体疲乏、认知疲乏、情感疲乏、综合疲乏评分下降幅度大于对照组(P<0.05)。观察组粒细胞减少、血小板减少、肝损伤、恶心呕吐、腹泻和黏膜炎症的总不良反应发生率均低于对照组(P<0.05)。结论:生态系统理论指导的营养管理可有效维持ALL化疗患儿的营养状态,提高患儿化疗耐受性。