文章摘要

多学科合作的个案管理在胃癌术后化疗患者营养支持中的应用

作者: 1郭苗苗, 1耿琪玮, 1王淑安, 1袁玲
1 南京大学医学院附属鼓楼医院肿瘤科,南京 210008
通讯: 袁玲 Email: yuanling73@hotmail.com
DOI: 10.3978/j.issn.2095-6959.2018.10.023
基金: 南京鼓楼医院护理部一般护理科研项目 (ZSA894-1)。

摘要

目的:探讨多学科合作个案管理模式下的营养干预对胃癌术后辅助化疗患者营养状况的影响。 方法:本试验为随机对照研究,单盲。随机表放在一个信封里由不参与此项研究的护士保存,依据患者就诊的次序,按照数字随机表连续编码分配给患者常规护理组和个案管理模式组,干预时间为28 d。比较两组营养风险评分(Nutritional Risk Score,NRS2002),主观营养指标(Patient-Generated Subjective Global Assessment,PG-SGA)、客观营养指标(体重、BMI、血清总蛋白、白蛋白)的变化情况。结果:多学科合作的个案管理模式与常规护理组具有基线可比性(P>0.05)。干预后个案管理模式组有营养风险的患者少于常规护理组(P<0.05),使用PG-SGA评价的干预组干预后较干预前营养状况提高(P<0.05)。个案管理模式与常规护理组总蛋白和白蛋白水平干预前差异无统计学意义,干预后差异有统计学意义(P<0.05)。结论:个案管理模式下的营养干预可改善胃癌术后辅助化疗患者营养状况,降低营养风险,但仍需要进行长期干预和随访来验证其远期效应。
关键词: 个案管理;化疗;营养支持;营养支持小组

Application of case management of multidisciplinary cooperation in nutritional support for postoperative chemotherapy patients with gastric cancer

Authors: 1GUO Miaomiao, 1GENG Qiwei, 1WANG Shu’an, 1YUAN Ling
1 Department of Oncology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China

CorrespondingAuthor: YUAN Ling Email: yuanling73@hotmail.com

DOI: 10.3978/j.issn.2095-6959.2018.10.023

Foundation: This work was supported by General Nursing Research Project from Nursing Department of Nanjing Drum Tower Hospital, China (ZSA894-1).

Abstract

Objective: To explore the effect of nutritional intervention on the nutritional status of patients with adjuvant chemotherapy after gastric cancer operation under the multidisciplinary cooperative case management model. Methods: This study was a randomized controlled study with single blindness. The random table was placed in an envelope and saved by nurses who did not participate in the study. According to the order of patient visits, the continuous random access code was assigned to the routine care group and case management mode group, the intervention time was 28 days. Objective to compare the changes of objective nutritional indicators (body weight, BMI, serum total protein, albumin), Nutritional Risk Score (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA) before and after intervention. Results: The case management model of multidisciplinary cooperation was comparable to that of the conventional nursing group (P>0.05). After intervention, the patients with nutritional risk in the case management group were less than the routine care group (P<0.05). The nutritional condition were improved to intervention group measured by PG-SGA (P<0.05). There were significant differences in the total protein and albumin level between the group and the group in the case management model (P<0.05). Conclusion: Nutritional intervention in case management mode can improve nutritional status and reduce nutrition risk, but long-term intervention and follow-up are needed to verify its long-term effect.
Keywords: case management; chemotherapy; nutrition support; nutrition support team

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