Nutritional Risk Screening and Comparison The Effect of Nutritional Support Among The Patients with Gastroin-testinal Major Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 KANGXin ¹ ,  HUYi ¹ , YANGYong ¹ , XULing ²

1. Department of General Surgery of Frist People's Hospital of Shuangliu, Shuangliu 610200, Sichuan Province, China;
2. Department of Scientific Education Information of Frist People's Hospital of Shuangliu, Shuangliu 610200, Sichuan Province, China;

Corresponding?author：

HUYi, Email: 345982554@qq.com

Keywords：

Gastrointestinal major surgery; Nutritional risk; Nutritional support; Clinical outcome

DOI：

10.7507/1007-9424.20140301

Video：

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Objective To investigate the prevalence of the nutritional risks, the relationship between application of nutritional support and the clinical outcome of patients with gastrointestinal major surgery in the Frist People's Hospital of Shuangliu. Methods Gastrointestinal major surgery patients in Department of General Surgery in the Frist People's Hospital of Shuangliu from March 2010 to March 2014 were consecutively enrolled. Patients who provided informed consent were screened by NRS 2002, tracking nutrition support status and analysis the relationship between nutrition support and clinical outcome. In this study, the clinical outcome index included postoperative complications and hospitalization time. Results There were totally 130 cases enrolled, 112 cases completed assessment by NRS 2002. The prevalence of nutritional risk was 75.9%(85/112), there were totally 57 patients(50.9%) received nutrition support, and all for parenteral nutrition. The prevalence of postoperative complication was 46.4%(52/112). The prevalence of postoperative complication in patients who had nutritional risk and received nutritional support was 41.7%(15/36), whereas, in patients who had nutritional risk but not received nutritional support was 73.5%(36/49), there was statistically significant difference between the 2 groups(P=0.002). In patients who not had nutritional risk, the postoperative complication rate was only 3.7%(1/27). Conclusions Because of noninvasive and easy to operate, NRS 2002 are adpted to hospitalized patients with gastrointestinal major surgery. Because of the specific of disease metabolism, the higher nutritional risk occurres in patients with gastrointestinal major surgery, appropriate nutritional support for this kinds of patients can reduce the incidence of postoperative complication, and improve the prognosis.

Citation： KANGXin, HUYi, YANGYong, XULing. Nutritional Risk Screening and Comparison The Effect of Nutritional Support Among The Patients with Gastroin-testinal Major Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1259-1263. doi: 10.7507/1007-9424.20140301 Copy

1.	The Veterans Affairs Total Parenteral Nutrition Cooperation Study Group. Perioperative total parenteral nutrition in surgical patients[J]. N Engl J Med, 1991, 325(8):525-532.
2.	Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4):415-421.
3.	蔣朱明, 于康, 朱賽楠, 等.我國東、中、西部中小醫院住院患者營養不良(足)、營養風險、超重和肥胖發生率及營養支持應用狀況調查(中期小結)[J].中國臨床營養雜志, 2008, 16(6):338-340.
4.	中華醫學會.臨床診療指南:腸外腸內營養學分冊[M].北京:人民衛生出版社, 2007:152-191.
5.	American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference:definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6):864-873.
6.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications:a new proposal with evaluation in a cohort of 6336 patients and results of a survey[J]. Ann Surg, 2004, 240(2):205-213.
7.	中華醫學會.住院患者營養風險篩查:臨床診療指南腸外腸內營養學分冊(2008版)[M].北京:人民衛生出版社, 2009:16-20.
8.	陳博, 伍曉汀.住院患者營養狀況評估[J].中國普外基礎與臨床雜志, 2011, 18(4):449-454.
9.	蔣朱明, 陳偉, 朱賽楠, 等.我國東中西部大城市三甲醫院營養不良(不足)、營養風險發生率及營養支持應用狀況調查[J].中國臨床營養雜志, 2008, 16(6):335-337.
10.	楊平, 陳博, 伍曉汀.胃癌住院患者營養風險及臨床營養支持現狀調查[J].中國普外基礎與臨床雜志, 2011, 18(6):620-624.
11.	Kondrup J, Sorensen JM. The magnitude of the problem of malnutrition in Europe[J]. Nestle Nutr Workshop Ser Clin Perform Program, 2009, 12:1-14.
12.	Liang XK, Jiang ZM, Nolan MT, et al. Comparative survey on nutritional risk and nutritional support between Beijing and Baltimore teaching hospitals[J]. Nutrition, 2008, 24(10):969-976.
13.	龐冬, 鄭凡凡, 寇京麗, 等.普外科醫護人員對營養風險篩查認知現狀調查[J].中國護理管理, 2010, 10(2):28-30.
14.	Senesse P, Assenat E, Schneider S, et al. Nutritional support during oncologic treatment of patients with gastrointestinal cancer:Who could benefit?[J]. Cancer Treat Rev, 2008, 3(4):568-575.
15.	黎介壽.圍手術期營養支持的需要性[J].腸外與腸內營養雜志, 2006, 13(3):129-131.
16.	于健春.腸內營養的理念及治療規范[J].臨床藥物治療雜志, 2009, 7(6):1-5.
17.	Huang YC, Yen CE, Cheng CH, et al. Nutritional status of mechanically ventilated critically ill patients:Comparison of different types of nutritional support[J]. Clin Nutr, 2000, 19(2):101-107.
18.	黎介壽.臨床營養支持策略的變遷[J].中國普外基礎與臨床雜志, 2009, 16(12):953-955.
19.	Johansen N, Kondrup J, Plum LM, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk[J]. Clin Nutr, 2004, 23(4):539-550.
20.	盧卓才, 湯漢林, 李新軍, 等.胃腸道腫瘤患者術前營養風險篩查80例分析[J].嶺南現代臨床外科, 2011, 11(6):434-436.
21.	王新穎, 李寧, 黎介壽.規范化營養支持在外科治療中的地位[J].外科理論與實踐, 2014, 19(1):16-20.
22.	Bankhead R, Boullata J, Brantley S, et al. Enteral nutrition practice recommendations[J]. J Parenter Enteral Nutr, 2009, 33(2):122-167.
23.	Miller CA, Grossman S, Hindley E, et al. Are enterally fed ICU patients meeting clinical practice guidelines?[J]. Nutr ClinPract, 2008, 23(5):642-650.
24.	沈志勇, 劉驊, 曹暉, 等.營養支持對胃腸道腫瘤患者術后營狀況及恢復的影響[J].消化外科, 2005, 4(4):229-232.
25.	王艷, 蔣朱明, 于康.臨床營養的經濟學研究進展[J].臨床藥物治療雜志, 2009, 7(6):42-46.

1. The Veterans Affairs Total Parenteral Nutrition Cooperation Study Group. Perioperative total parenteral nutrition in surgical patients[J]. N Engl J Med, 1991, 325(8):525-532.
2. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4):415-421.
3. 蔣朱明, 于康, 朱賽楠, 等.我國東、中、西部中小醫院住院患者營養不良(足)、營養風險、超重和肥胖發生率及營養支持應用狀況調查(中期小結)[J].中國臨床營養雜志, 2008, 16(6):338-340.
4. 中華醫學會.臨床診療指南:腸外腸內營養學分冊[M].北京:人民衛生出版社, 2007:152-191.
5. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference:definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6):864-873.
6. Dindo D, Demartines N, Clavien PA. Classification of surgical complications:a new proposal with evaluation in a cohort of 6336 patients and results of a survey[J]. Ann Surg, 2004, 240(2):205-213.
7. 中華醫學會.住院患者營養風險篩查:臨床診療指南腸外腸內營養學分冊(2008版)[M].北京:人民衛生出版社, 2009:16-20.
8. 陳博, 伍曉汀.住院患者營養狀況評估[J].中國普外基礎與臨床雜志, 2011, 18(4):449-454.
9. 蔣朱明, 陳偉, 朱賽楠, 等.我國東中西部大城市三甲醫院營養不良(不足)、營養風險發生率及營養支持應用狀況調查[J].中國臨床營養雜志, 2008, 16(6):335-337.
10. 楊平, 陳博, 伍曉汀.胃癌住院患者營養風險及臨床營養支持現狀調查[J].中國普外基礎與臨床雜志, 2011, 18(6):620-624.
11. Kondrup J, Sorensen JM. The magnitude of the problem of malnutrition in Europe[J]. Nestle Nutr Workshop Ser Clin Perform Program, 2009, 12:1-14.
12. Liang XK, Jiang ZM, Nolan MT, et al. Comparative survey on nutritional risk and nutritional support between Beijing and Baltimore teaching hospitals[J]. Nutrition, 2008, 24(10):969-976.
13. 龐冬, 鄭凡凡, 寇京麗, 等.普外科醫護人員對營養風險篩查認知現狀調查[J].中國護理管理, 2010, 10(2):28-30.
14. Senesse P, Assenat E, Schneider S, et al. Nutritional support during oncologic treatment of patients with gastrointestinal cancer:Who could benefit?[J]. Cancer Treat Rev, 2008, 3(4):568-575.
15. 黎介壽.圍手術期營養支持的需要性[J].腸外與腸內營養雜志, 2006, 13(3):129-131.
16. 于健春.腸內營養的理念及治療規范[J].臨床藥物治療雜志, 2009, 7(6):1-5.
17. Huang YC, Yen CE, Cheng CH, et al. Nutritional status of mechanically ventilated critically ill patients:Comparison of different types of nutritional support[J]. Clin Nutr, 2000, 19(2):101-107.
18. 黎介壽.臨床營養支持策略的變遷[J].中國普外基礎與臨床雜志, 2009, 16(12):953-955.
19. Johansen N, Kondrup J, Plum LM, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk[J]. Clin Nutr, 2004, 23(4):539-550.
20. 盧卓才, 湯漢林, 李新軍, 等.胃腸道腫瘤患者術前營養風險篩查80例分析[J].嶺南現代臨床外科, 2011, 11(6):434-436.
21. 王新穎, 李寧, 黎介壽.規范化營養支持在外科治療中的地位[J].外科理論與實踐, 2014, 19(1):16-20.
22. Bankhead R, Boullata J, Brantley S, et al. Enteral nutrition practice recommendations[J]. J Parenter Enteral Nutr, 2009, 33(2):122-167.
23. Miller CA, Grossman S, Hindley E, et al. Are enterally fed ICU patients meeting clinical practice guidelines?[J]. Nutr ClinPract, 2008, 23(5):642-650.
24. 沈志勇, 劉驊, 曹暉, 等.營養支持對胃腸道腫瘤患者術后營狀況及恢復的影響[J].消化外科, 2005, 4(4):229-232.
25. 王艷, 蔣朱明, 于康.臨床營養的經濟學研究進展[J].臨床藥物治療雜志, 2009, 7(6):42-46.

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Nutritional Risk Screening and Comparison The Effect of Nutritional Support Among The Patients with Gastroin-testinal Major Surgery

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