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.	蒋朱明, 于康, 朱赛楠, 等.我国东、中、西部中小医院住院患者营养不良(足)、营养风险、超重和肥胖发生率及营养支持应用状况调查(中期小结)[J].中国临床营养杂志, 2008, 16(6):338-340.
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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.
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9.	蒋朱明, 陈伟, 朱赛楠, 等.我国东中西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查[J].中国临床营养杂志, 2008, 16(6):335-337.
10.	杨平, 陈博, 伍晓汀.胃癌住院患者营养风险及临床营养支持现状调查[J].中国普外基础与临床杂志, 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.	庞冬, 郑凡凡, 寇京丽, 等.普外科医护人员对营养风险筛查认知现状调查[J].中国护理管理, 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.	黎介寿.围手术期营养支持的需要性[J].肠外与肠内营养杂志, 2006, 13(3):129-131.
16.	于健春.肠内营养的理念及治疗规范[J].临床药物治疗杂志, 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.	黎介寿.临床营养支持策略的变迁[J].中国普外基础与临床杂志, 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.	卢卓才, 汤汉林, 李新军, 等.胃肠道肿瘤患者术前营养风险筛查80例分析[J].岭南现代临床外科, 2011, 11(6):434-436.
21.	王新颖, 李宁, 黎介寿.规范化营养支持在外科治疗中的地位[J].外科理论与实践, 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, 刘骅, 曹晖, 等.营养支持对胃肠道肿瘤患者术后营状况及恢复的影响[J].消化外科, 2005, 4(4):229-232.
25.	王艳, 蒋朱明, 于康.临床营养的经济学研究进展[J].临床药物治疗杂志, 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. 蒋朱明, 于康, 朱赛楠, 等.我国东、中、西部中小医院住院患者营养不良(足)、营养风险、超重和肥胖发生率及营养支持应用状况调查(中期小结)[J].中国临床营养杂志, 2008, 16(6):338-340.
4. 中华医学会.临床诊疗指南:肠外肠内营养学分册[M].北京:人民卫生出版社, 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. 中华医学会.住院患者营养风险筛查:临床诊疗指南肠外肠内营养学分册(2008版)[M].北京:人民卫生出版社, 2009:16-20.
8. 陈博, 伍晓汀.住院患者营养状况评估[J].中国普外基础与临床杂志, 2011, 18(4):449-454.
9. 蒋朱明, 陈伟, 朱赛楠, 等.我国东中西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查[J].中国临床营养杂志, 2008, 16(6):335-337.
10. 杨平, 陈博, 伍晓汀.胃癌住院患者营养风险及临床营养支持现状调查[J].中国普外基础与临床杂志, 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. 庞冬, 郑凡凡, 寇京丽, 等.普外科医护人员对营养风险筛查认知现状调查[J].中国护理管理, 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. 黎介寿.围手术期营养支持的需要性[J].肠外与肠内营养杂志, 2006, 13(3):129-131.
16. 于健春.肠内营养的理念及治疗规范[J].临床药物治疗杂志, 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. 黎介寿.临床营养支持策略的变迁[J].中国普外基础与临床杂志, 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. 卢卓才, 汤汉林, 李新军, 等.胃肠道肿瘤患者术前营养风险筛查80例分析[J].岭南现代临床外科, 2011, 11(6):434-436.
21. 王新颖, 李宁, 黎介寿.规范化营养支持在外科治疗中的地位[J].外科理论与实践, 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, 刘骅, 曹晖, 等.营养支持对胃肠道肿瘤患者术后营状况及恢复的影响[J].消化外科, 2005, 4(4):229-232.
25. 王艳, 蒋朱明, 于康.临床营养的经济学研究进展[J].临床药物治疗杂志, 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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