全程营养教育方案在胰十二指肠切除术患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.15.012

摘要/Abstract

摘要：

目的基于干预图构建胰十二指肠切除术患者全程营养教育方案并探讨其应用效果，旨在为临床护理实践提供借鉴。方法采用便利抽样法，选取在安徽省某三级甲等医院肝胆胰外科拟行胰十二指肠切除术的76例患者作为研究对象。2022年10月—2023年7月入院的38例患者作为试验组，2021年10月—2022年9月入院的38例患者作为对照组。试验组接受该研究构建的全程营养教育方案，对照组采用常规营养健康教育措施，两组干预时长为预住院至出院后6个月。比较两组营养相关指标、术后并发症发生率、住院天数、住院费用和营养教育满意度。结果 64例完成研究，其中试验组33例，对照组31例。重复测量方差分析结果显示，两组BMI、血清总蛋白、前白蛋白的时间与组间存在交互效应（P<0.05）。试验组的并发症发生率、住院天数和住院费用均低于对照组，差异具有统计学意义（P<0.05）。试验组的营养教育满意度评分高于对照组，差异具有统计学意义（P<0.001）。结论实施全程营养教育方案可一定程度改善胰十二指肠切除术患者的营养状况，减少并发症的发生，促进患者康复。

关键词: 干预图, 胰十二指肠切除术, 肠内营养, 肠外营养, 护理

Abstract:

Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application，aiming at providing references for clinical nursing practice. Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects. The 38 patients admitted from October 2021 to September 2022 were in a control group，and the 38 patients admitted from October 2022 to July 2023 were in an experimental group. The experimental group received the comprehensive nutritional education programme constructed in this study，and the control group used conventional nutrition health education measures，and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months. Nutrition-related indicators，postoperative complications，hospitalisation time，hospitalisation costs and satisfaction were compared between the 2 groups. Results A total of 64 patients completed this study，with 33 in the experimental group and 31 in the control group. Repeated measurement analysis of variance showed that the interaction effects of BMI，total serum protein and serum preprotein were statistically significant（P<0.05）. The incidence of complications，hospitalization days and hospitalization costs of the experimental group were lower than those of the control group（P<0.05）. The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group（P<0.001）. Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent，reduce the occurrence of complications，and promote patients’ recovery.

Key words: Intervention Mapping, Pancreaticoduodenectomy, Nursing Care, Enteral Nutrition, Parenteral Nutrition

毕淑敏, 姚远远, 范云珊, 方颖, 江明媚, 周佳, 贺琰琳, 任春霞. 全程营养教育方案在胰十二指肠切除术患者中的应用研究[J]. 中华护理杂志, 2025, 60(15): 1871-1878.

BI Shumin, YAO Yuanyuan, FAN Yunshan, FANG Ying, JIANG Mingmei, ZHOU Jia, HE Yanlin, REN Chunxia. A study of a comprehensive nutrition education program in patients undergoing pancreaticoduodenectomy[J]. Chinese Journal of Nursing, 2025, 60(15): 1871-1878.

图/表 5

表1 胰十二指肠切除术患者全程营养教育方案

Table 1 Draft of a comprehensive nutrition education programme for PD patients

表2 两组一般资料的比较

Table 3 Comparison of general information between 2 groups

表3 两组BMI、血清总蛋白和前白蛋白的比较（$\bar{x} \pm s$）

Table 3 Comparison of BMI, total protein and preprotein between 2 groups （$\bar{x} \pm s$）

表4 不同时间节点两组上臂围、上臂皮褶和腹部皮褶的比较（$\bar{x} \pm s$）

Table 4 Comparison of upper arm circumference，upper arm skin fold and abdominal skin fold at different time nodes between 2 groups（$\bar{x} \pm s$）

表5 两组临床结局和营养教育满意度的比较

Table 5 Comparison of clinical outcomes and satisfaction related to nutrition education between 2 groups

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