The Effect of Full Nutritional Management Model on Perioperative Nutritional Status in Patients with Head and Neck Malignancies_West China Medical Journal

Authors：

 WANGXiao-ping ,  DENGChun-meng , WANGJie , JIANGZhen-hua , LIYing , PENGHuan

Department of Otolaryngology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

DENGChun-meng, Email: mywxlc@163.com

Keywords：

Full nutritional management; Nutritional evaluation; Malignant tumor; Head and neck; Nutrition Support Team; Mode

DOI：

10.7507/1002-0179.20140562

Video：

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Objective To explore the effect of full nutritional management pattern on perioperative nutritional status in patients with head and neck malignancies. Methods Sixty-four patients with head and neck cancer treated in our department between March 2012 and June 2013 were randomly divided into control group and study group with 32 in each. The control group received conventional dietary guidance, while patients in the study group were given full nutritional management. Nutritional Risk Screening Scale 2002 (NRS-2002) was used for nutrition screening and assessment before surgery (after admission) and after surgery (3 days after surgery). The study group received full nutritional support, along with nutrition-related physical examination and biochemical tests, and observation of postoperative complications, and hospital stay and costs were also observed. Results Nutritional risk existed in 29.7%-48.4% of the head and neck cancer patients during various stages of the perioperative period. Through the full nutritional support, patients in the study group had a significantly lower risk than those in the control group (P<0.01). Body mass index, triceps skinfold thickness, mid-arm muscle circumference, prealbumin, and creatinine in the study group were significantly more improved compared with the control group (P<0.01). No significant difference was detected in blood urea and serum albumin between the two groups. Postoperative complications in the study group was significantly lower (P<0.05), and hospital stay and costs were significantly lower than the control group (P<0.001). Conclusion Full nutritional management pattern can significantly improve the perioperative nutritional status in head and neck cancer patients. Early detection of nutritional risk and malnutrition (foot) in the patients and carrying out normal and scientific nutrition intervention are helpful in the rehabilitation of these patients. We suggest that qualified hospitals should carry out the full nutritional management model managed by a Nutrition Support Team for patients with malignancies.

Citation： WANGXiao-ping, DENGChun-meng, WANGJie, JIANGZhen-hua, LIYing, PENGHuan. The Effect of Full Nutritional Management Model on Perioperative Nutritional Status in Patients with Head and Neck Malignancies. West China Medical Journal, 2014, 29(10): 1845-1848. doi: 10.7507/1002-0179.20140562 Copy

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11.	蔡东联. 临床营养学回顾与展望[J]. 武警医学, 2003, 14(3):131-135.
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15.	刘新梅, 黄志刚, 陈晓红. 微型营养评价法在头颈恶性肿瘤患者营养状况筛查中的研究[J]. 中国医疗前沿, 2008, 3(6):24-25.
16.	黎介寿. 肿瘤营养学的兴起及临床应用[J]. 中国临床营养杂志, 2004, 12(4):221-222.
17.	潘玲, 毛德强. NRS-2002评估473例首诊恶性肿瘤患者营养状况[J]. 重庆医学, 2013, 42(10):1117-1118, 1121.
18.	刘绍严, 徐震纲, 屠规益. 头颈恶性肿瘤临床专业化的需求[J]. 中华肿瘤杂志, 2011, 33(1):76-77.

1. Couch M, Lai V, Cannon T, et al. Cancer eachexia syndrome in head and neck cancer patients:Part 1. Diagnosis, impact on quality of life and surriva1 and treatment[J]. Head Neck, 2007, 29(4):401-411.
2. CSCO肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识[J]. 临床肿瘤学杂志, 2012, 17(1):59-70.
3. Kondrup JE, Rasmussen HH, Hamberg OL, et al. Nutritional risk screening (NRS 2002):a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3):321-336.
4. 蒋朱明, 于康, 李海龙. 营养支持对有营养风险患者结局的影响[J]. 中华临床营养杂志, 2010, 18(5):263-267.
5. 中华医学会.临床诊疗指南:肠内肠外营养学分册[M]. 北京:人民卫生出版社, 2006:15-19.
6. 张小田, 张联, 曹伟新, 等. 恶性肿瘤患者的循证营养支持[J]. 临床外科杂志, 2008, 16(12):801-803.
7. 曹伟新. 围手术期肿瘤患者营养支持疗法的认识和实践[J]. 中华临床营养杂志, 2012, 20(2):65-68.
8. 张颐, 蒋朱明. 营养筛查、评定与干预是成人营养诊疗的关键步骤:美国肠外肠内营养学会(ASPEN) 2011年临床指南[J]. 中华临床营养杂志, 2012, 20(5):261-268.
9. Amaral TF, Antunes A, Cabral S, et al. An evaluation of three nutritional screening tools in a Portuguese oncology centre[J]. J Human Nutr Dietet, 2008, 21(6):575-583.
10. 詹斯·康卓普, 雷米·梅耶.营养风险筛查2002改善临床结局[J]. 中华临床营养杂志, 2013, 21(3):133-139.
11. 蔡东联. 临床营养学回顾与展望[J]. 武警医学, 2003, 14(3):131-135.
12. 王建, 易龙, 舒晓亮, 等. 我国临床营养学科的现状与存在问题[J]. 中国食物与营养, 2012, 18(7):5-9.
13. 曹伟新, 费旭峰. 建立临床营养支持专业队伍的意义[J]. 外科理论与实践, 2002, 7(1):8-10.
14. 王晓兰. 喉癌术后患者营养支持的临床研究[J]. 医药论坛杂志, 2004, 25(5):16-18.
15. 刘新梅, 黄志刚, 陈晓红. 微型营养评价法在头颈恶性肿瘤患者营养状况筛查中的研究[J]. 中国医疗前沿, 2008, 3(6):24-25.
16. 黎介寿. 肿瘤营养学的兴起及临床应用[J]. 中国临床营养杂志, 2004, 12(4):221-222.
17. 潘玲, 毛德强. NRS-2002评估473例首诊恶性肿瘤患者营养状况[J]. 重庆医学, 2013, 42(10):1117-1118, 1121.
18. 刘绍严, 徐震纲, 屠规益. 头颈恶性肿瘤临床专业化的需求[J]. 中华肿瘤杂志, 2011, 33(1):76-77.

West China Medical Journal

The Effect of Full Nutritional Management Model on Perioperative Nutritional Status in Patients with Head and Neck Malignancies

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