胃癌术后患者居家饮食与营养管理的研究进展
Advances in Home-Based Dietary and Nutritional Management for Post-Gastrectomy Patients
DOI: 10.12677/ns.2025.1411272, PDF,    科研立项经费支持
作者: 孙 星, 李苇苇, 严佳依, 王 虹, 忻海琴, 袁 园*:宁波市第二医院胃肠外科,浙江 宁波
关键词: 综述胃癌术后居家饮食管理营养管理Review Post-Gastrectomy Home-Based Dietary Management Nutritional Management
摘要: 胃癌术后由于各种因素影响,造成患者术后营养不良的发生率高,患者营养状态对胃癌术后患者的短期和长期结局均有重大影响,因此胃癌患者术后居家饮食与营养管理至关重要。本文在确认主题及关键词后,通过计算机检索中国生物医学文献数据库、万方、中国知网、维普、Cochrane Library、PubMed、Embase、CINAHL、Web of Science等国内外数据库,对胃癌术后患者饮食与营养管理的重要性、饮食与营养管理的需求与问题、饮食管理工具及干预现状进行综述,提出国内目前饮食与营养管理需要解决的问题,以期为开展胃癌术后患者的饮食与营养管理的相关研究提供参考。
Abstract: Due to various factors, the incidence of malnutrition is high after gastric cancer surgery, and patients’ nutritional status significantly impacts both short-term and long-term outcomes. Therefore, home-based dietary and nutritional management is crucial for post-gastrectomy patients. After defining the topic and keywords, we comprehensively searched domestic and international databases including CBM, Wanfang Data, CNKI, VIP, Cochrane Library, PubMed, Embase, CINAHL, and Web of Science. This review summarizes the importance of dietary and nutritional management, identifies existing needs and problems, examines dietary management tools and current intervention status, and highlights issues requiring resolution in China, which is aiming to provide references for future research on dietary and nutritional management for post-gastrectomy patients.
文章引用:孙星, 李苇苇, 严佳依, 王虹, 忻海琴, 袁园. 胃癌术后患者居家饮食与营养管理的研究进展[J]. 护理学, 2025, 14(11): 2029-2036. https://doi.org/10.12677/ns.2025.1411272

参考文献

[1] Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. [Google Scholar] [CrossRef] [PubMed]
[2] 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读[J]. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
[3] Nishida, T., Blay, J., Hirota, S., Kitagawa, Y. and Kang, Y. (2015) The Standard Diagnosis, Treatment, and Follow-Up of Gastrointestinal Stromal Tumors Based on Guidelines. Gastric Cancer, 19, 3-14. [Google Scholar] [CrossRef] [PubMed]
[4] 李子禹, 闫超, 李沈. 胃癌围手术期营养治疗中国专家共识(2019版) [J]. 中国实用外科杂志, 2020, 40(2): 145-151.
[5] Oh, S.E., Choi, M., Seo, J., An, J.Y., Lee, J.H., Sohn, T.S., et al. (2019) Prognostic Significance of Perioperative Nutritional Parameters in Patients with Gastric Cancer. Clinical Nutrition, 38, 870-876. [Google Scholar] [CrossRef] [PubMed]
[6] Ocón Bretón, M.J., Luengo Pérez, L.M., Virizuela, J.A., Álvarez Hernández, J., Jiménez Fonseca, P., Cervera Peris, M., et al. (2018) Soporte nutricional y nutrición parenteral en el paciente oncológico: Informe de consenso de un grupo de expertos. Endocrinología, Diabetes y Nutrición, 65, 17-23. [Google Scholar] [CrossRef
[7] 于海荣. 食管癌手术患者饮食训练方案的构建及初步应用[D]: [硕士学位论文]. 苏州: 苏州大学, 2019.
[8] 屈清荣, 杨程舒, 何卫芳, 等. 胃癌根治术后患者化疗期营养风险的动态评估及饮食指导启示[J]. 中国实用护理杂志, 2017, 33(16): 1201-1204.
[9] 秦霞, 茆勇, 赵杰, 等. 胃癌术后患者居家饮食改变体验的质性研究[J]. 中国实用护理杂志, 2021, 37(23): 1801-1805.
[10] 李慧, 梁秀凤. 胃癌术后患者对延续性护理服务需求的调查[J]. 中国实用护理杂志, 2017, 33(17): 1303-1306.
[11] Ryu, S.W., Son, Y.G. and Lee, M.K. (2020) Motivators and Barriers to Adoption of a Healthy Diet by Survivors of Stomach Cancer: A Cross-Sectional Study. European Journal of Oncology Nursing, 44, Article ID: 101703. [Google Scholar] [CrossRef] [PubMed]
[12] 谢艳艳, 任晖, 张燕, 等. 护士主导的个体化营养教育对胃癌术后康复早期患者营养状况的影响[J]. 齐鲁护理杂志, 2020, 26(18): 1-4.
[13] Sagar, R.C., Kumar, K.V.V., Ramachandra, C., Arjunan, R., Althaf, S. and Srinivas, C. (2019) Perioperative Artificial Enteral Nutrition in Malnourished Esophageal and Stomach Cancer Patients and Its Impact on Postoperative Complications. Indian Journal of Surgical Oncology, 10, 460-464. [Google Scholar] [CrossRef] [PubMed]
[14] Mak, M., Bell, K., Ng, W. and Lee, M. (2016) Nutritional Status, Management and Clinical Outcomes in Patients with Esophageal and Gastro‐Oesophageal Cancers: A Descriptive Study. Nutrition & Dietetics, 74, 229-235. [Google Scholar] [CrossRef] [PubMed]
[15] Lee, H.O., Han, S.R., Choi, S.I., Lee, J.J., Kim, S.H., Ahn, H.S., et al. (2016) Effects of Intensive Nutrition Education on Nutritional Status and Quality of Life among Postgastrectomy Patients. Annals of Surgical Treatment and Research, 90, 79-88. [Google Scholar] [CrossRef] [PubMed]
[16] 宋春花, 王昆华, 郭增清, 等. 中国常见恶性肿瘤患者营养状况调查[J]. 中国科学: 生命科学, 2020, 50(12): 1437-1452.
[17] 曾颖, 谢金懿, 林淑洁, 等. 胃癌术后患者居家营养管理的最佳证据总结[J]. 现代临床护理, 2025, 24(7): 83-92.
[18] 苏甜. 胃癌患者术后膳食营养知信行调查研究[D]: [硕士学位论文]. 石家庄: 河北医科大学, 2018.
[19] 李燕, 朱慧娣. 胃癌患者饮食评估及影响因素研究进展[J]. 护理与康复, 2023, 22(2): 87-91.
[20] Warne, C., Forrester, I.T., Jones, L. and Morley, J.E. (2019) Screening for the Anorexia of Aging. The Journal of nutrition, health and aging, 23, 398-400. [Google Scholar] [CrossRef] [PubMed]
[21] Matsushita, Y., Takahashi, T., Asahi, K., Harashima, E., Takahashi, H., Tanaka, H., et al. (2021) Validation of Improved 24-Hour Dietary Recall Using a Portable Camera among the Japanese Population. Nutrition Journal, 20, Article No. 68. [Google Scholar] [CrossRef] [PubMed]
[22] Huang, K., Zhao, L., Fang, H., Yu, D., Yang, Y., Li, Z., et al. (2022) A Preliminary Study on a Form of the 24-H Recall That Balances Survey Cost and Accuracy, Based on the NCI Method. Nutrients, 14, Article 2740. [Google Scholar] [CrossRef] [PubMed]
[23] 田秋菊. 胃癌术后居家患者经口营养护理实践方案的构建[D]: [博士学位论文]. 上海: 上海交通大学, 2020.
[24] 汪丹丹, 郑蔚, 乔婷婷, 等. 胃癌术后患者参与饮食管理对其营养状况影响的研究[J]. 中华护理杂志, 2017, 52(4): 389-394.
[25] 钟萍. 科普化词条创建法联合七日饮食日记在胃癌术后患者饮食管理中的应用研究[J]. 国际护理学杂志, 2019, 38(11): 1611-1613.
[26] 马永红. 西北地区学龄前儿童半定量食物频率问卷的编制及膳食模式研究[D]: [博士学位论文]. 西安: 中国人民解放军空军军医大学, 2020.
[27] Kim, J.H., Lee, J., Choi, I.J., Kim, Y. and Kim, J. (2020) Dietary Patterns and Gastric Cancer Risk in a Korean Population: A Case–control Study. European Journal of Nutrition, 60, 389-397. [Google Scholar] [CrossRef] [PubMed]
[28] Tran, H., Sengngam, K., Pham, P. and Le, N. (2021) Case-Control Study of Alcohol Usage and Fruit Intake and Stomach Cancer in the North Viet Nam. Asian Pacific Journal of Cancer Prevention, 22, 2903-2908. [Google Scholar] [CrossRef] [PubMed]
[29] Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S.C., et al. (2017) ESPEN Guidelines on Definitions and Terminology of Clinical Nutrition. Clinical Nutrition, 36, 49-64. [Google Scholar] [CrossRef] [PubMed]
[30] 于康, 李增宁, 丛明华, 等. 恶性肿瘤患者康复期营养管理专家共识[J]. 营养学报, 2017, 39(4): 321-326.
[31] Poulia, K., Klek, S., Doundoulakis, I., Bouras, E., Karayiannis, D., Baschali, A., et al. (2017) The Two Most Popular Malnutrition Screening Tools in the Light of the New ESPEN Consensus Definition of the Diagnostic Criteria for Malnutrition. Clinical Nutrition, 36, 1130-1135. [Google Scholar] [CrossRef] [PubMed]
[32] Bauer, J., Capra, S. and Ferguson, M. (2002) Use of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as a Nutrition Assessment Tool in Patients with Cancer. European Journal of Clinical Nutrition, 56, 779-785. [Google Scholar] [CrossRef] [PubMed]
[33] Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., et al. (2017) ESPEN Guidelines on Nutrition in Cancer Patients. Clinical Nutrition, 36, 11-48. [Google Scholar] [CrossRef] [PubMed]
[34] 黄英隆, 高洁, 吴日英, 等. 胃癌病人围术期营养知识调查[J]. 护理研究, 2015, 29(3): 343-344.
[35] 刘玉芬, 姚楠, 张颖梅, 等. 参与式饮食护理对胃癌根治术后患者营养状况的影响[J]. 中华现代护理杂志, 2018, 24(16): 1908-1911.
[36] 何晓兰, 周雪玲, 蔡蕾. 以家庭为中心护理模式对胃癌术后病人居家营养状况的影响[J]. 全科护理, 2018, 16(9): 1064-1066.
[37] 黄迎春, 王新颖, 彭南海. 家庭营养支持病人网络访视及护理干预效果评价[J]. 护理研究, 2015, 29(10): 3733-3736.
[38] Martin, K. and McGinnis, C. (2016) Home Nutrition Support: Ethics and Reimbursement. Nutrition in Clinical Practice, 31, 325-333. [Google Scholar] [CrossRef] [PubMed]
[39] Meng, Q., Tan, S., Jiang, Y., Han, J., Xi, Q., Zhuang, Q., et al. (2021) Post-Discharge Oral Nutritional Supplements with Dietary Advice in Patients at Nutritional Risk after Surgery for Gastric Cancer: A Randomized Clinical Trial. Clinical Nutrition, 40, 40-46. [Google Scholar] [CrossRef] [PubMed]
[40] 姬倞. 胃癌术后患者居家营养管理方案的构建[D]: [硕士学位论文]. 湖州: 湖州师范学院, 2022.
[41] Bowrey, D.J., Baker, M., Halliday, V., Thomas, A.L., Pulikottil-Jacob, R. and Smith, K. (2014) Six Weeks of Home Enteral Nutrition versus Standard Care after Esophagectomy or Total Gastrectomy for Cancer: Study Protocol for a Randomized Controlled Trial. Trials, 15, Article No. 187. [Google Scholar] [CrossRef] [PubMed]
[42] Hamada, S., Komatsu, S., Shibata, R., et al. (2020) Better Effect of Home Night Enteral Nutrition in an Elderly Patient Following Laparoscopic Total Gastrectomy for Advanced Gastric Cancer. Gan To Kagaku Ryoho, 47, 2030-2031.
[43] 熊伟昕, 胡丽君, 伍淑文. 微信随访方式改善胃癌患者术后营养状况[J]. 消化肿瘤杂志(电子版), 2017, 9(2): 139-142.
[44] Baker, M.L., Halliday, V., Robinson, P., Smith, K. and Bowrey, D.J. (2017) Nutrient Intake and Contribution of Home Enteral Nutrition to Meeting Nutritional Requirements after Oesophagectomy and Total Gastrectomy. European Journal of Clinical Nutrition, 71, 1121-1128. [Google Scholar] [CrossRef] [PubMed]
[45] Arosi, I., Heyes, K., Sibanda, V. and Sundar, R. (2018) Tele-Cancer: Reducing Time-To-Treatment for Patients with Lung Cancer. European Respiratory Journal, 52, PA2835.
[46] 杨园园, 蒋晓涵, 龚亚博, 等. 营养状况在胃癌病人营养知信行与生活质量间的中介效应研究[J]. 肠外与肠内营养, 2023, 30(2): 109-113.
[47] Seckman, C. and Van de Castle, B. (2020) Understanding Digital Health Technologies Using Mind Maps. Journal of Nursing Scholarship, 53, 7-15. [Google Scholar] [CrossRef] [PubMed]
[48] 孙可盈, 贺方园, 张柔, 等. 数字健康技术在妊娠期糖尿病患者营养管理中的应用进展[J]. 中华护杂志, 2025, 60(14): 1694-1699.