【摘要】 目的 利用人體成分分析儀測定腫瘤化療患者人體組成,進而探討腫瘤化療患者人體成分組成特點及與營養狀況的關系。 方法 用人體成分分析儀于2008年4-5月對50例腫瘤化療患者行人體成分測定并分析。 結果 腫瘤化療患者人體細胞內液、外液,體內水分、蛋白質、礦物質、骨骼肌含量等成分存在不足,且有30％的腫瘤化療患者體脂肪含量過剩,40％體脂肪百分比超標。 結論 腫瘤化療患者由于疾病自身的高消耗,化療藥物對機體的影響,導致攝入不足,營養狀況較差,各成分含量均異常。其營養問題應受到重視,并采取積極有效的營養支持以改善營養狀況。【Abstract】 Objective To detect the body compositions of patients with carcinoma who had undergone chemotherapy, and to analyze the features of the composition and its relationship with nutritional status. Methods Bioelectrical impedance analyzer was used to measure and analyze the body compositions of 50 patients who was underwent chemotherapy from April to May 2008. Results The compositions such as intracellular and extracellular water, total body water, protein, minerals, skeletal muscle mass were insufficient in patients who had undergone chemotherapy; 30% of the patients had excess body fat, and 40% of the patients′ body fat percent was over standard. Conclusion Because of the high consumption of disease itself and the effects of chemotherapy drugs on the body, the intake of the patients who have undergone chemotherapy is insufficient and the nutritional status is poor. We should actively evaluate their nutritional status and do some effective nutritional supports to improve the nutritional status of patients with carcinoma who have undergone chemotherapy.
ObjectiveTo explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.MethodsA retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.ResultsThe detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).ConclusionUsing SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.
ObjectiveTo explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.MethodsCOVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.ResultsA total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).ConclusionsCOVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.
【摘要】 目的 探討海洋肽對惡性腫瘤化學治療（簡稱化療）患者營養狀況和免疫功能的影響。 方法 依照納入排除標準選取2010年3－11月66例惡性腫瘤化療患者，隨機分為試驗組和對照組，每組各33例。在正常飲食基礎上，試驗組和對照組分別服用海洋肽制劑和乳清蛋白制劑21 d，進行肝腎功能、營養狀況及免疫指標的測定。 結果 干預前后兩組肝腎功及血脂指標差異無統計學意義（Pgt;0.05），且均在正常范圍內。試驗組干預后體質指數（body mass index，BMI）、上臂圍、上臂肌圍、總蛋白、白蛋白、球蛋白、前白蛋白（prealbumin，PA）、轉鐵蛋白較干預前升高有統計學意義（Plt;0.05），而血紅蛋白和三頭肌皮褶厚度干預前后比較差異無統計學意義（Pgt;0.05）；對照組干預前后各指標差異均無統計學意義（Pgt;0.05）；試驗組BMI、PA的前后差值較對照組高（Plt;0.05），而其他指標差值在兩組間差異無統計學意義（Pgt;0.05）。兩組在干預前后組內比較及組間免疫指標差值比較，差異均無統計學意義（Pgt;0.05）。 結論 海洋肽作為部分氮源應用于惡性腫瘤化療患者，對患者的內臟蛋白、人體測量等均有一定的營養改善作用，但對免疫功能的影響不明顯，尚待進一步研究。【Abstract】 Objective To investigate the effects of marine peptide on the nutritional status and immune function in malignant tumor patients undergoing chemotherapy. Methods According to inclusive and exclusive criteria, 66 malignant tumor patients undergoing chemotherapy from March 2010 to November 2010 were randomized into study group and control group with 33 patients in each group. The patients in the study group were given marine collagen peptide whey protein while those in the control group were given whey protein for 21 days. Liver and kidney function, nutritional status and immune function were observed before and after intervention. Results Liver, kidney function and blood lipids of all the patients were within normal range, and were not significantly different between the two groups before and after intervention (P＞0.05). After intervention, body mass index (BMI), arm circumference, arm muscle circumference, total protein, albumin, globulin, prealbumin (PA), transferring protein of the study group were significantly increased (P＜0.05), but hemoglobin and triceps skinfold thickness had no significant changes (P＞0.05). There was no significant difference of the above parameters in the control group before and after intervention (P＞0.05). The magnitude of change of PA and BMI before and after intervention were higher in the study group than those in the control group (P＜0.05), while the magnitude of change of other parameters before and after intervention showed no significant difference between the two groups (P＞0.05). The immune function showed no significant change in both groups before and after intervention (P＞0.05), and it was also not significantly different between the two groups. Conclusion As part of dietary nitrogen sources, marine peptide can significantly improve nutritional status, including visceral protein and anthropometry in malignant tumor patients undergoing chemotherapy, but it has no significant effect on immune function, which should be further studied in detail.
During the medical rescue of Wenchuan earthquake, on the condition of ensuring the security of producing environment and food, following the four concepts including standard production, instant cooling technology, networking management and nutrition guidance, the CPU of West China Hospital stopped the production of possibly uncontrolled food, developed a reasonable plan for materials in stock, reinforced the inspection of sources of raw materials and quality of food, adjusted styles of dishes, proviced made special food for the wounded and their relatives from different districts and nationalities, new dishes for the wounded and the medical staff, so as not only to assure the nutrition for the slightly wounded, but also to provide the individualized nutrition treatment for the severely wounded. A total of 70 077 person-times for the wounded from the disaster area (36 330 person-times for the wounded and 33 747 person-times for their family members), and 36 273 person-times for doctors and nurses have been served. Meanwhile, the food service has also been offered as regular to other patients and hospital staff, with a maximum of 18 372 person-times per day.
Objective To explore the generalizability and implementation effectiveness of standardized clinical pathways of food for special medical purpose (FSMP). Methods From November 10, 2023 to November 30, 2023, a pilot study for the standardized clinical pathway of FSMP in medical institutions was conducted at Nanjing Drum Tower Hospital (the Affiliated Hospital of Nanjing University Medical School), Chenzhou First People’s Hospital, and the Second People’s Hospital of Yibin. The hospitalized patients using FSMP in these three hospitals were continuously included to analyze the feasibility and effectiveness of the pathway. Results A total of 99 patients were included. The overall effect evaluation of the pathway showed that the proportion of convenient medical order (96.9%), timely delivery (100.0%), and easy storage (96.9%) were relatively high. The proportion of patients with good compliance was 88.9%, the proportion of patients who achieved treatment goals was 51.5%, and the proportion of patients who suspended the use of FSMP in advance was 19.2%. The incidence of gastrointestinal complications, metabolic complications, and infectious complications in patients were relatively low (<30%), and the median (lower quartile, upper quartile) satisfaction scores for patients, family members, and nurses were all 9.0 (8.0, 10.0) points. There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different prescribing personnel (P>0.05). There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different nutritional support methods (P>0.05). Conclusions The FSMP clinical pathway pilot has performed well in terms of convenience, compliance, satisfaction, with a low incidence of complications. The pathway is effective and safe, and can be widely applied.
ObjectivesTo use the Delphi method to preliminarily perfect the comprehensive evaluation index system which had been initially constructed by systematic review processes of diabetes food for special medical purposes (FSMP).MethodsThree rounds of expert consultation by Delphi method were compared to define indices held in the evidence-based comprehensive evaluation index system of diabetes FSMP and ways to distinguish effects.ResultsThe preliminary perfect index system after 3 rounds of expert consultation contained 4 primary directory indicators, 15 secondary directory indicators, and 20 tertiary indicators. Among them, the end index which could directly be used for evaluation contained a total of 27 indicators.ConclusionsThe index system is categorized into 4 segments of parameters, which are medical, nutritional, safety and other indices, which has addressed the problem posed by CFDA documents on how to scientifically validate the medical effect and safety of FSMP. It provides great significance to assess and supervise FSMP prior to and after it goes to public, assess characteristics and advantages of MNT, and improves nutrition economy and its social benefits.
The essence of ensuring universal nutritional health lies in achieving a balance between the growing demand for nutritional health and the supply of adequate and balanced nutritional services. This paper learns and draws on the ideological theory and methodological support of evidence-based science, optimizing practices, reevaluations, monitoring risks, producing evidence and cultivating talents so as to enable the interdisciplines of evidence-based nutrition and develop in a localized way and gain optimal timeliness, quantity and quality.
