全国医疗数据库研究,用于手术后的营养管理,在接受胃肠道癌症手术的患者
Yoshikuni Kawaguchi1, Kenta Murotani2,3, Nahoki Hayashi4
1Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine The University of Tokyo Tokyo Japan.
胃肠癌手术后的营养管理因手术地点而异. 早期的口服摄入至关重要,但只有不到一半的禁食患者获得了推的亲肠道营养剂量,这凸显了改善方案和教育的需要.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床营养学 临床营养学
背景情况:
- 手术后营养管理对于胃肠癌手术后的康复至关重要.
- 手术部位的变化可以影响营养支持策略和患者的结果.
研究的目的:
- 为了研究经过胃肠癌手术的患者的营养管理.
- 在手术后的最初7天内,根据手术部位分析营养护理.
主要方法:
- 利用日本医疗索赔数据库 (2011-2022) 来识别胃肠癌手术患者.
- 根据手术部位对患者进行分类,并评估术后食路线和口服开始时间.
- 在术后第7天的禁食患者中评估了目标亲肠道营养 (能量和氨基酸) 剂量.
主要成果:
- 根据手术部位,口服的开始有很大差异,最早发生在肝脏手术后 (中位数为第二天),最晚发生在食道手术后 (中位数为第7天).
- 在禁食患者中,不到一半的患者在术后第7天接受了指导方针推的腹腔能量 (20千卡/千克) 和氨基酸 (0.8克/千克) 剂量.
- 在手术地点之间观察到患者接受目标剂量比例的显著差异,食道手术患者在禁食患者中显示出最高的能量和氨基酸处方率.
结论:
- 胃肠道癌症手术后的口服摄入开始取决于地点,肝脏手术患者最早开始,食道手术患者最晚开始.
- 目前对禁食患者的肠外营养处方实践不足以达到大量患者推的目标剂量.
- 加强教育和遵守指导方针是必要的,以优化在胃肠道癌症手术后的患者群体中早期口服养和亲肠道营养.
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