全面推进全程营养管理在外科中的应用

Comprehensively promoting the application of whole‑course nutritional management in surgery

  • 摘要: 手术是治疗外科疾病的主要手段,但对机体是一次创伤应激,引起机体代谢变化和营养受损,加上原发外科疾病以及基础疾病的影响,外科患者在术前、术中、术后以及出院后的不同阶段常存在不同程度的代谢变化和营养不良。任一阶段的代谢变化和营养受损都将相互影响,最终降低患者的外科治疗效果,影响短期和长期临床结局。营养治疗的理念和技术近几十年获得迅猛发展,临床应用极大提高了疾病救治成功率。全面推进全程营养管理在外科中的应用,将营养筛查‑评估‑干预贯穿于术前、术中、术后以及出院后整个疾病治疗和康复过程,可发挥营养治疗的最大疗效,加速术后康复,改善患者预后。笔者结合临床实践与文献资料,探讨全程营养管理的重要性和必要性、首要任务、关键措施、最后保障。

     

    Abstract: Surgery is the main approach for treating surgical diseases, but it can bring traumatic stress to the body, causing metabolic changes and nutritional deficiencies. In addition to the primary surgical disease, the underlying health condition can also have an impact, and thus, at different stages, including preoperative, intraoperative, postoperative, and post‑discharge, surgical patients often experience varying degrees of metabolic changes and malnutrition. These metabolic changes and nutritional deficiencies at any stage can mutually influence each other, ultimately reducing the therapeutic effect of surgical treatment and affecting both short‑term and long‑term clinical outcomes. The concept and techniques of nutritional therapy have undergone rapid deve-lopment in recent decades, greatly improving the success rate of disease treatment. It is recommen-ded to promote the application of whole‑course nutritional management in surgery, which integrates nutritional screening, assessment, and intervention throughout the entire process of preoperative, intraoperative, postoperative, and post‑discharge care during the disease treatment and recovery process. This approach can maximize the therapeutic benefits of nutritional therapy, accelerate postoperative recovery, and improve patient′s prognosis. Based on clinical practices and literatures, the author explores the importance and necessity, primary tasks, key measures, and final guarantees of whole‑course nutritional management.

     

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