Clinical effect of sequential nutritional intervention model on improving early nutritional status of patients with gastric cancer after operation_West China Medical Journal

Authors：

ZHOU Yingshuyi ¹ , FU Xiaojun ² , YUAN Yuan ¹ , WU Guifang ¹ , JIANG Ziqi ³ , CHEN Ping ¹ ,  FAN Xiaoxiang ⁴ ,  GUO Shuyan ⁵

1. Department of Gastrointestinal Surgery, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, P. R. China;
2. Nursing Department, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, P. R. China;
3. Department of Thoracic Surgery, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, P. R. China;
4. Information Department, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, P. R. China;
5. National Institute of Hospital Administration, National Health Commission, Beijing 100083, P. R. China;

Corresponding?author：

FAN Xiaoxiang, Email: doctor_kingcrimson@163.com; GUO Shuyan, Email: guoshuyan@niha.org.cn

Keywords：

Gastric cancer; sequential nutritional intervention; quality control circle activities; nutrition management; quality of life

DOI：

10.7507/1002-0179.202411101

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Objective To explore the effect of sequential nutritional intervention mode on improving early postoperative nutritional status in patients with gastric cancer. Methods A total of 30 patients who underwent radical gastrectomy for gastric cancer in the Department of Gastrointestinal Surgery, Ningbo No.2 Hospital between June and August 2022 were selected as the tiral group by convenience sampling, and another 30 patients who underwent radical gastrectomy for gastric cancer between September 2021 and January 2022 were retrospectively selected as the control group. The trial group received the sequential nutritional intervention model constructed by quality control circle activities in the Department of Gastrointestinal Surgery, and the control group received routine nutritional support. The nutritional status and quality of life of the two groups were evaluated one month after discharge. Results Before intervention, there was no statistically significant difference in the Patient-Generated Subjective Global Assessment (PG-SGA) score, serum albumin, serum prealbumin, body weight, or Quality of Life Questionnaire Core 30 (QLQ C30) score between the two groups (P>0.05). After intervention, both groups showed improvements in PG-SGA score, serum albumin, and serum prealbumin compared to before intervention (P<0.05); there was no significant change in body weight in the trial group (P>0.05), while the control group experienced a decrease in body weight (P<0.05); the trial group showed an improvement in QLQ C30 score (P<0.05), whereas the control group did not show significant change in QLQ C30 score (P>0.05). Compared to the control group after intervention, the trial group showed better PG-SGA score (7.97±1.65 vs. 8.83±1.26), serum albumin level [(40.61±1.30) vs. (39.93±0.78) g/L], serum prealbumin level [(0.266±0.030) vs. (0.229±0.051) g/L], body weight [(63.12±7.39) vs. (58.17±9.18) kg], and QLQ C30 score (62.63±9.01 vs. 57.23±7.13), with all differences being statistically significant (P<0.05). Conclusion Sequential nutritional intervention model is helpful to improve the early nutritional status and quality of life of patients after radical gastrectomy, and has clinical promotion value.

Citation： ZHOU Yingshuyi, FU Xiaojun, YUAN Yuan, WU Guifang, JIANG Ziqi, CHEN Ping, FAN Xiaoxiang, GUO Shuyan. Clinical effect of sequential nutritional intervention model on improving early nutritional status of patients with gastric cancer after operation. West China Medical Journal, 2024, 39(12): 1899-1904. doi: 10.7507/1002-0179.202411101 Copy

1.	袁士杰, 史征, 楊俊馳, 等. 雙通道重建手術與全胃切除術對胃癌患者術后營養狀況的影響. 第二軍醫大學學報, 2020, 41(1): 32-36.
2.	英圣艷, 路潛, 任暉, 等. 胃癌根治術患者飲食及營養狀況的調查. 護理管理雜志, 2013, 13(8): 549-551.
3.	蘇甜. 胃癌患者術后膳食營養知信行調查研究. 石家莊: 河北醫科大學, 2018.
4.	成洋, 賀娟, 周小莉. 早期精細化護理干預聯合序貫式營養治療對腦卒中后吞咽功能障礙患者的療效觀察. 中國醫刊, 2024, 59(7): 741-745.
5.	蔣萍萍, 耿美玉, 李瑞. 基于營養風險篩查的序貫式營養干預對老年髖部骨折手術病人的影響. 循證護理, 2024, 10(6): 1122-1125.
6.	謝亞敏. 營養替代療法對胃癌患者術后化療期間營養狀態和生活質量的影響. 重慶醫學, 2021, 50(1): 32-64.
7.	宋青龍, 靳和平. 序貫性早期腸內營養與康復鍛煉對胃癌患者術后營養狀況的影響及安全性. 青島醫藥衛生, 2024, 56(4): 290-293.
8.	盛英麗, 張春麗. 品管圈活動在提升面癱住院病人健康宣教內容執行率中的應用效果. 護理研究, 2023, 37(6): 1117-1120.
9.	Liu Y, Lin B. Application of quality control circle in the treatment of moderate cancer pain in inpatients. Jpn J Clin Oncol, 2020, 50(5): 581-585.
10.	中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會胃癌臨床診療指南(2021 版). 中華醫學雜志, 2022, 102(16): 1169-1189.
11.	游利江, 葛杰, 劉婷, 等. NRS 2002 和 PG-SGA 在胃腸道惡性腫瘤患者中的應用. 胃腸病學, 2023, 28(7): 432-436.
12.	Xu YC, Vincent JI. Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review. Nutr J, 2020, 19(1): 106.
13.	石軍梅, 王曉翔, 劉英, 等. EORTC QLQ-C30 量表應用于胃癌術后化療患者的信效度檢驗. 河北醫科大學學報, 2015, 36(4): 448-451.
14.	高加蓉, 陳錦, 柏楊. 品管圈在提升研究型醫院品質中的運用與實踐探索. 中國醫院管理, 2016, 36(12): 90-91.
15.	姬倞. 胃癌術后患者居家營養管理方案的構建. 湖州: 湖州師范學院, 2022.
16.	何棟, 樊萬里, 張樹澤, 等. 肌肉減少癥與胃癌的相關研究. 華西醫學, 2023, 38(7): 1091-1095.
17.	費超男, 段培蓓, 楊玲, 等. 胃癌患者圍手術期營養管理的最佳證據總結. 中華護理雜志, 2022, 57(19): 2345-2352.
18.	陳博, 熊茂明, 孟翔凌. 臨床營養支持在圍手術期患者中的應用. 華西醫學, 2017, 32(8): 1303-1307.
19.	李政焰, 趙永亮, 錢鋒, 等. 機器人遠端胃癌根治術后并發癥的 Clavien-Dindo 分級及危險因素分析. 腹腔鏡外科雜志, 2020, 25(1): 15-20.
20.	顏廷啟, 王清馨, 劉博, 等. 胃癌術后早期應用免疫增強型腸內營養制劑聯合腸外營養的療效分析. 現代消化及介入診療, 2020, 25(9): 1224-1227.
21.	崔小麗, 宋春蒙. 腸內腸外營養支持序貫對重癥患者營養狀況、炎癥因子及并發癥的影響. 牡丹江醫學院學報, 2021, 42(4): 116-119.
22.	肖霞, 李中福, 郭軼, 等. 經鼻-空腸腸內營養對胃癌根治術后患者營養狀況、炎癥反應及并發癥的影響. 貴州醫科大學學報, 2021, 46(10): 1226-1230.
23.	周玲, 汪歡, 鄒莞. 營養序貫護理模式對行胃癌根治術患者營養狀況及術后并發癥的影響. 中西醫結合護理(中英文), 2022, 8(4): 121-123.
24.	周雪玲, 蔡蕾, 粟靜. 胃癌根治術后早期序貫腸內營養支持與全腸外營養的隨機對照研究. 中國實用醫藥, 2017, 12(16): 106-107.
25.	遲俊濤. 消化道腫瘤患者圍手術期營養不良對臨床結局的影響研究. 北京: 中國協和醫科大學, 2010.

1. 袁士杰, 史征, 楊俊馳, 等. 雙通道重建手術與全胃切除術對胃癌患者術后營養狀況的影響. 第二軍醫大學學報, 2020, 41(1): 32-36.
2. 英圣艷, 路潛, 任暉, 等. 胃癌根治術患者飲食及營養狀況的調查. 護理管理雜志, 2013, 13(8): 549-551.
3. 蘇甜. 胃癌患者術后膳食營養知信行調查研究. 石家莊: 河北醫科大學, 2018.
4. 成洋, 賀娟, 周小莉. 早期精細化護理干預聯合序貫式營養治療對腦卒中后吞咽功能障礙患者的療效觀察. 中國醫刊, 2024, 59(7): 741-745.
5. 蔣萍萍, 耿美玉, 李瑞. 基于營養風險篩查的序貫式營養干預對老年髖部骨折手術病人的影響. 循證護理, 2024, 10(6): 1122-1125.
6. 謝亞敏. 營養替代療法對胃癌患者術后化療期間營養狀態和生活質量的影響. 重慶醫學, 2021, 50(1): 32-64.
7. 宋青龍, 靳和平. 序貫性早期腸內營養與康復鍛煉對胃癌患者術后營養狀況的影響及安全性. 青島醫藥衛生, 2024, 56(4): 290-293.
8. 盛英麗, 張春麗. 品管圈活動在提升面癱住院病人健康宣教內容執行率中的應用效果. 護理研究, 2023, 37(6): 1117-1120.
9. Liu Y, Lin B. Application of quality control circle in the treatment of moderate cancer pain in inpatients. Jpn J Clin Oncol, 2020, 50(5): 581-585.
10. 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會胃癌臨床診療指南(2021 版). 中華醫學雜志, 2022, 102(16): 1169-1189.
11. 游利江, 葛杰, 劉婷, 等. NRS 2002 和 PG-SGA 在胃腸道惡性腫瘤患者中的應用. 胃腸病學, 2023, 28(7): 432-436.
12. Xu YC, Vincent JI. Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review. Nutr J, 2020, 19(1): 106.
13. 石軍梅, 王曉翔, 劉英, 等. EORTC QLQ-C30 量表應用于胃癌術后化療患者的信效度檢驗. 河北醫科大學學報, 2015, 36(4): 448-451.
14. 高加蓉, 陳錦, 柏楊. 品管圈在提升研究型醫院品質中的運用與實踐探索. 中國醫院管理, 2016, 36(12): 90-91.
15. 姬倞. 胃癌術后患者居家營養管理方案的構建. 湖州: 湖州師范學院, 2022.
16. 何棟, 樊萬里, 張樹澤, 等. 肌肉減少癥與胃癌的相關研究. 華西醫學, 2023, 38(7): 1091-1095.
17. 費超男, 段培蓓, 楊玲, 等. 胃癌患者圍手術期營養管理的最佳證據總結. 中華護理雜志, 2022, 57(19): 2345-2352.
18. 陳博, 熊茂明, 孟翔凌. 臨床營養支持在圍手術期患者中的應用. 華西醫學, 2017, 32(8): 1303-1307.
19. 李政焰, 趙永亮, 錢鋒, 等. 機器人遠端胃癌根治術后并發癥的 Clavien-Dindo 分級及危險因素分析. 腹腔鏡外科雜志, 2020, 25(1): 15-20.
20. 顏廷啟, 王清馨, 劉博, 等. 胃癌術后早期應用免疫增強型腸內營養制劑聯合腸外營養的療效分析. 現代消化及介入診療, 2020, 25(9): 1224-1227.
21. 崔小麗, 宋春蒙. 腸內腸外營養支持序貫對重癥患者營養狀況、炎癥因子及并發癥的影響. 牡丹江醫學院學報, 2021, 42(4): 116-119.
22. 肖霞, 李中福, 郭軼, 等. 經鼻-空腸腸內營養對胃癌根治術后患者營養狀況、炎癥反應及并發癥的影響. 貴州醫科大學學報, 2021, 46(10): 1226-1230.
23. 周玲, 汪歡, 鄒莞. 營養序貫護理模式對行胃癌根治術患者營養狀況及術后并發癥的影響. 中西醫結合護理(中英文), 2022, 8(4): 121-123.
24. 周雪玲, 蔡蕾, 粟靜. 胃癌根治術后早期序貫腸內營養支持與全腸外營養的隨機對照研究. 中國實用醫藥, 2017, 12(16): 106-107.
25. 遲俊濤. 消化道腫瘤患者圍手術期營養不良對臨床結局的影響研究. 北京: 中國協和醫科大學, 2010.

West China Medical Journal

Clinical effect of sequential nutritional intervention model on improving early nutritional status of patients with gastric cancer after operation

Abstract Full text Figures/Tables Video References Cited by

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