由专科护士对晚期结直肠癌化疗患者进行营养干预的多学科团队方法：一项临床试验。
A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial.
作者信息
Lin Jin-Xiang, Chen Xiang-Wei, Chen Zhan-Hong, Huang Xiu-Yan, Yang Jin-Jie, Xing Yan-Fang, Yin Liang-Hong, Li Xing, Wu Xiang-Yuan
机构信息
Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University Department of Nephrology, the Third Affiliated Hospital of Guangzhou Medical University Department of Nephrology, First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
出版信息
Medicine (Baltimore). 2017 Jun;96(26):e7373. doi: 10.1097/MD.0000000000007373.
BACKGROUND & AIMS: Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients.
METHODS
This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points.
RESULTS
There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P < .05). In the control group, weight did not change during ordinary diet guidance. Serum albumin level was slightly improved after 12 cycles of chemotherapy, similar to the prealbumin results. There were statistically significant differences in serum albumin and prealbumin levels between the intervention and control groups after nutrition intervention (P < .05). However, there was no statistically significant difference in weight between the groups after nutrition intervention (P > .05).
CONCLUSION
A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.
背景与目的
针对癌症患者营养不良的营养干预可能会有所帮助。然而，简洁的干预建议仍存在争议。因此，本研究的目的是报告由专科护士多学科团队进行的营养干预，并探讨营养干预对癌症患者的影响。
方法
这项前瞻性临床试验研究纳入了110名接受化疗的结直肠癌患者。入院时使用2002年营养风险筛查系统（NRS - 2002）对患者进行评估。患者被随机分为干预组和对照组，每组各55名患者。对照组患者给予正常饮食，而干预组患者接受由专业护士、临床医生、营养师、家庭护理人员和患者自身组成的团队制定的个性化食谱。在不同时间点比较两组患者的体重、血清白蛋白和前白蛋白水平。
结果
干预组营养干预前后患者体重、血清白蛋白和前白蛋白水平存在显著差异（P<0.05）。对照组在普通饮食指导期间体重未发生变化。化疗12个周期后血清白蛋白水平略有改善，前白蛋白结果类似。营养干预后干预组和对照组血清白蛋白和前白蛋白水平存在统计学显著差异（P<0.05）。然而，营养干预后两组间体重无统计学显著差异（P>0.05）。
结论
由专科护士采用多学科团队方法进行的营养干预改善了接受化疗的结直肠癌患者的前白蛋白水平，体重无变化。
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