Büntzel J, Büntzel H, Micke O, Mücke R
Klinik für HNO-Krankheiten, Kopf-Hals-Chirurgie, Südharz-Krankenhaus Nordhausen gGmbH, Dr.-Robert-Koch-Str. 39, 99734, Nordhausen, Deutschland.
HNO. 2011 Nov;59(11):1139-47; quiz 1148-9. doi: 10.1007/s00106-011-2414-9.
Tumours of the upper aerodigestive tract cause malnutrition in the majority of ENT cancer patients. This situation is complicated by multimodal treatment regimens (including surgery and/or irradiation). The resulting malnutrition is a disease entity in its own right and requires special treatment concepts. Effective screening tools (NRS 2002) need to be introduced and data such as body mass index and bioimpedance analysis need to be gathered. The nutrition plan for individual ENT patients differs according to the grade of malnutrition and dysphagia. Oral nutrition should always form the basis of any nutrition programme, such that logopedic therapy is required in all cases of dysphagia. Artifical, oral high-energy nutrition is a pharmacological procedure as well as enteral feeding via PEG or PEJ. Partial or total parenteral nutrition (central venous access) should be restricted to crisis interventions or fast-track regimens.
上消化道肿瘤在大多数耳鼻喉科癌症患者中会导致营养不良。多模式治疗方案(包括手术和/或放疗)使这种情况更加复杂。由此产生的营养不良本身就是一种疾病实体,需要特殊的治疗理念。需要引入有效的筛查工具(营养风险筛查2002),并收集体重指数和生物电阻抗分析等数据。根据营养不良和吞咽困难的程度,针对个体耳鼻喉科患者的营养计划会有所不同。口服营养应始终是任何营养方案的基础,因此在所有吞咽困难的病例中都需要言语治疗。人工口服高能营养既是一种药物治疗方法,也是通过经皮内镜下胃造口术(PEG)或经皮内镜下空肠造口术(PEJ)进行肠内喂养。部分或全胃肠外营养(中心静脉通路)应仅限于危机干预或快速康复方案。