护士主导的体重丢失控制管理方案对胰腺癌围术期患者营养状况的影响 [中文引用][英文引用]

目的  探讨由护士主导的体重丢失控制管理方案在胰腺癌围术期患者中的应用效果。方法  采用便利抽样法，选取 2023 年 6 月— 2024 年 6 月在本院就诊并行胰腺癌根治术的 207 例患者作为研究对象，其中 2023 年 6 月— 12 月 105 例患者为对照组，2024 年 1 月— 6 月 102 例患者为试验组。对照组采用胰腺外科常规护理，试验组采用由护士主导的体重丢失控制管理方案。比较两组患者干预前后体重丢失率、上臂围、小腿围、握力、血清白蛋白、血红蛋白、前白蛋白的变化值及术后并发症发生率。结果  干预后 2w 试验组患者体重丢失率与握力、上臂围、上臂肌围、小腿围与血红蛋白、前白蛋白下降值小于对照组，两组比较，差异具有统计学意义（均 P<0.05）。试验组术后 IIIa 级及以上并发症发生率低于对照组，两组比较，差异具有统计学意义（P<0.001）。结论  护士主导的体重丢失控制管理方案可有效降低胰腺癌患者术后体重丢失率，减少骨骼肌功能耗损力。

Objective To evaluate the effectiveness of a nurse-led weight loss control and management protocol in improving nutrition status of the perioperative patients with pancreatic cancer. Methods 207 patients scheduled for radical resection of pancreatic cancer in our centre from June 2023 to June 2024 with convenience sampling. The patients admitted between June and December 2023 （n=105）were assigned to the control group and received standard pancreatic surgical care,and those were admitted between January and June 2024（n=102）were assigned to the trial group and received a nurse-led weight loss control and management protocol. Changes in involuntary weight loss ratio,mid-upper arm circumference（MUAC）,calf circumference,handgrip strength,serum albumin, haemoglobin,prealbumin,together with postoperative complication rates,were compared. Results Weight change ratio changes in hand-grip strength,mid-upper arm circumference,calf circumference,differences in haemoglobin,pre-albumin were significantly less thar those in the trial group（all P<0.05）,The incidence of complications at grade IIIa and above was lower in the trial group（P<0.001）. Conclusion A nurse-led weight loss control protocol can safely and effectively reduce postoperative weight loss ratio,mitigate skeletal muscle functional depletion.