食管癌患者营养筛查与评估工具在临床护理中的应用进展

doi:10.3761/j.issn.0254-1769.2026.01.019

摘要/Abstract

摘要：

食管癌患者因机械性梗阻和高代谢状态，营养不良发生率极高，严重影响其临床结局，临床中准确的营养筛查与评估是实施有效营养支持的基础。然而，现有工具并非专为食管癌患者设计，其在该人群中的应用效度与特性亟待验证。该文对现有国内外常用的营养筛查工具与营养评估工具进行汇总，继而对其在食管癌患者中的应用进行综述，对不同类型食管癌患者营养筛查与评估工具进行比较分析，提出临床应用建议，为后续构建针对食管癌患者营养筛查与评估工具提供参考，以优化食管癌患者的营养管理。

关键词: 食管癌, 营养筛查, 营养评估, 综述, 护理

Abstract:

Patients with esophageal cancer have a very high incidence of malnutrition due to mechanical obstruction and hyper-metabolic state，which seriously affects clinical outcomes. Accurate nutritional screening and assessment in clinical practice are the basis for implementing effective nutritional support. However，the existing tools are not specifically designed for patients with esophageal cancer，and their validity and characteristics in this population need to be verified urgently. This paper summarizes and compiles the commonly used domestic and international nutritional screening tools and nutritional assessment tools，and subsequently reviews their application in esophageal cancer patients. A comparative analysis of nutritional screening and assessment tools for different types of esophageal cancer patients，with recommendations for clinical application. The aim is to provide references for developing systematic and individualized nutritional screening and assessment strategies specifically tailored for esophageal cancer patients，thereby optimizing nutritional management for this population.

Key words: Esophageal Cancer, Nutrition Screening, Nutrition Assessment, Review, Nursing Care

周芳萍, 缪艳琴, 王鑫钰. 食管癌患者营养筛查与评估工具在临床护理中的应用进展[J]. 中华护理杂志, 2026, 61(1): 130-136.

ZHOU Fangping, MIAO Yanqin, MIAO Yanqin, WANG Xinyu. Progress in the application of nutritional screening and assessment tools for esophageal cancer patients in clinical nursing[J]. Chinese Journal of Nursing, 2026, 61(1): 130-136.

参考文献 41

[1]	郑渊杰, 滕熠, 何思怡, 等. 2022年全球及中国食管癌流行病学特征[J]. 中国肿瘤, 2025, 34(3):165-170.
	Zheng YJ, Teng Y, He SY, et al. Epidemiological characteristics of esophageal cancer worldwide and in China,2022[J]. China Cancer, 2025, 34(3):165-170.
[2]	Song CH, Cao JJ, Zhang F, et al. Nutritional risk assessment by scored patient-generated subjective global assessment associa-ted with demographic characteristics in 23,904 common ma-lignant tumors patients[J]. Nutr Cancer, 2019, 71(1):50-60. DOI URL
[3]	李涛, 李宝生, 吕家华, 等. 食管癌患者营养治疗指南[J]. 肿瘤代谢与营养电子杂志, 2020, 7(1):32-42.
	Li T, Li BS, Lü JH, et al. Guidelines for nutritional treatment of esophageal cancer patients[J]. Electron J Metab Nutr Cancer, 2020, 7(1):32-42.
[4]	费超男, 段培蓓, 杨玲, 等. 胃癌患者围手术期营养管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(19):2345-2352. DOI URL
	Fei CN, Duan PB, Yang L, et al. Evidence summary of nutri-tional management in patients with gastric cancer during the perioperative period[J]. Chin J Nurs, 2022, 57(19):2345-2352.
[5]	Gomes F, Schuetz P, Bounoure L, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients[J]. Clin Nutr, 2018, 37(1):336-353. DOI PMID
[6]	陈伟, 蒋朱明, 张永梅, 等. 欧洲营养不良风险调查方法在中国住院患者的临床可行性研究[J]. 中国临床营养杂志, 2005, 13(3):137-141.
	Chen W, Jiang ZM, Zhang YM, et al. Evaluation of European nutritional risk screening method in Chinese hospitalized patients practice[J]. Chin J Clin Nutr, 2005, 13(3):137-141.
[7]	胡银燕, 赵林芳, 贺晓映, 等. 1例食管癌术后并发重度免疫检查点抑制剂相关肺炎及吻合口瘘患者的护理[J]. 中华护理杂志, 2024, 59(14):1752-1756.
	Hu YY, Zhao LF, He XY, et al. Nursing care of a postoperative patient with esophageal cancer complicated by severe immune checkpoint inhibitor-related pneumonia and anastomotic fistula[J]. Chin J Nurs, 2024, 59(14):1752-1756.
[8]	李小娟, 练玉颖, 杨宇. 营养风险筛查2002、微型营养评定简化版和老年营养风险指数在老年食管癌病人营养风险筛查中的应用[J]. 安徽医药,2024, 28(12):2443-2447.
	Li XJ, Lian YY, Yang Y. Application of Nutritional Risk Scree-ning 2002,Mini Nutritional Assessment Short-form,and Geriatric Nutritional Risk Index in screening nutritional risk among elderly patients with esophageal cancer[J]. Anhui Med Pharm J,2024, 28(12):2443-2447.
[9]	Woo J, Chumlea WC, Sun SS, et al. Development of the Chinese Nutrition Screen(CNS) for use in institutional settings[J]. J Nutr Health Aging, 2005, 9(4):203-210. PMID
[10]	Vlacich G, Samson PP, Perkins SM, et al. Treatment utilization and outcomes in elderly patients with locally advanced eso-phageal carcinoma:a review of the National Cancer Database[J]. Cancer Med, 2017, 6(12):2886-2896. DOI URL
[11]	李星. 食管癌患者不同筛查工具营养筛查的对比研究[J]. 实用临床医药杂志, 2016, 20(20):154-155.
	Li X. Comparative study on nutritional screening of esopha-geal cancer patients with different screening tools[J]. J Clin Med Pract, 2016, 20(20):154-155.
[12]	Bouillanne O, Morineau G, Dupont C, et al. Geriatric Nutritio-nal Risk Index:a new index for evaluating at-risk elderly medical patients[J]. Am J Clin Nutr, 2005, 82(4):777-783. DOI PMID
[13]	崔娜, 张勇勤, 蒋冠华, 等. 老年人营养风险筛查工具研究现状及应用分析[J]. 中国医学创新, 2022, 19(31):184-188.
	Cui N, Zhang YQ, Jiang GH, et al. Research status and application analysis of nutritional risk screening tools for the elderly[J]. Med Innov China, 2022, 19(31):184-188.
[14]	Henderson S, Moore N, Lee E, et al. Do the malnutrition uni-versal screening tool(MUST) and Birmingham nutrition risk(BNR) score predict mortality in older hospitalised patients?[J]. BMC Geriatr, 2008,8:26.
[15]	蒋慧. 营养风险筛查2002、营养不良通用筛查工具和患者主观整体评估在住院肿瘤患者中的应用[J]. 河南医学研究,2020, 29(2):226-228.
	Jiang H. Nutritional Risk Screening 2002,application of Uni-versal Malnutrition Screening Tool and Subjective overall eva-luation of patients in hospitalized cancer patients[J]. Henan Med Res, 2020, 29(2):226-228.
[16]	Zhang LY, Lu YH, Fang Y. Nutritional status and related factors of patients with advanced gastrointestinal cancer[J]. Br J Nutr, 2014, 111(7):1239-1244. DOI URL
[17]	石汉平, 李薇, 齐玉梅, 等. 营养筛查与评估[M]. 2版. 北京: 人民卫生出版社, 2021.
	Shi HP, Li W, Qi YM, et al. Nutrition screening and assess-ment[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2021.
[18]	Wischmeyer PE, Carli F, Evans DC, et al. American society for enhanced recovery and perioperative quality initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway[J]. Anesth Analg, 2018, 126(6):1883-1895. DOI PMID
[19]	吴江林. 围手术期营养筛查在加速康复外科老年患者中的应用评价[J]. 中国老年保健医学, 2024, 22(5):44-48.
	Wu JL. Evaluation of the application of PONS in elderly patients in accelerated rehabilitation surgery[J]. Chin J Geriatr Care, 2024, 22(5):44-48.
[20]	Ignacio de Ulíbarri J, González-Madroño A, de Villar NP, et al. CONUT:a tool for controlling nutritional status. First vali-dation in a hospital population[J]. Nutr Hosp, 2005, 20(1):38-45. PMID
[21]	Rinninella E, Borriello R, D’Angelo M, et al. COntrolling NUTri-tional status(CONUT) as predictive score of hospital length of stay(LOS) and mortality:a prospective cohort study in an internal medicine and gastroenterology unit in Italy[J]. Nu-trients, 2023, 15(6):1472.
[22]	Westergren A, Norberg E, Vallén C, et al. Cut-off scores for the Minimal Eating Observation and Nutrition Form-version Ⅱ (MEONF-Ⅱ) among hospital inpatients[J]. Food Nutr Res, 2011,55:55.
[23]	季单单, 徐建鸣. 微型饮食观察营养筛查量表的汉化及信度效度检验[J]. 中国护理管理, 2021, 21(8):1158-1163.
	Ji DD, Xu JM. Translation and reliability and validity of Chinese version of Minimal Eating Observation and Nutrition Form-version Ⅱ(MEONF-Ⅱ)[J]. Chin Nurs Manag, 2021, 21(8):1158-1163.
[24]	Rubenstein LZ, Harker JO, Salvà A, et al. Screening for under-nutrition in geriatric practice:developing the Short-Form Mini-Nutritional Assessment(MNA-SF)[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6):M366-M372.
[25]	Söderhamn U, Söderhamn O. Developing and testing the nutri-tional form for the elderly[J]. Int J Nurs Pract, 2001, 7(5):336-341. DOI PMID
[26]	高涵, 刘堃. 老年人营养量表中文版的信效度评价[J]. 中国全科医学, 2014, 17(17):2045-2047.
	Gao H, Liu K. Nutritional Form for the Elderly(Chinese ver-sion):evaluation of reliability and validity[J]. Chin Gen Pract, 2014, 17(17):2045-2047.
[27]	Detsky AS, Baker JP, Mendelson RA, et al. Evaluating the accu-racy of nutritional assessment techniques applied to hospita-lized patients:methodology and comparisons[J]. J Parenter Ente-ral Nutr, 1984, 8(2):153-159.
[28]	Ottery FD. Rethinking nutritional support of the cancer patient:the new field of nutritional oncology[J]. Semin Oncol, 1994, 21(6):770-778. PMID
[29]	殷鸿, 邓明珍, 王益芳, 等. 三种营养筛查工具对食管癌患者营养不良的评价比较[J]. 肿瘤预防与治疗, 2021, 34(2):127-132.
	Yin H, Deng MZ, Wang YF, et al. Evaluation and comparison of three nutrition screening tools for malnutrition in esopha-geal cancer patients[J]. J Cancer Contr Treat, 2021, 34(2):127-132.
[30]	Makhija S, Baker J. The Subjective Global Assessment:a review of its use in clinical practice[J]. Nutr Clin Pract, 2008, 23(4):405-409. DOI PMID
[31]	王子兵, 李小玢, 刘海珍, 等. 63例男性食管癌患者术前营养状况和不同营养筛查评估方法比较[J]. 潍坊医学院学报, 2021, 43(6):459-463.
	Wang ZB, Li XF, Liu HZ, et al. Comparison of preoperative nutritional status and different nutritional screening and evaluation methods in 63 male patients with esophageal cancer[J]. Acta Acad Med Weifang, 2021, 43(6):459-463.
[32]	Dubhashi SP, Kayal A. Preoperative nutritional assessment in elderly cancer patients undergoing elective surgery:MNA or PG-SGA?[J]. Indian J Surg, 2015, 77(Suppl 2):232-235. DOI PMID
[33]	Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritio-nal index in gastrointestinal surgery[J]. Am J Surg, 1980, 139(1):160-167. DOI PMID
[34]	Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients[J]. Nihon Geka Gakkai Zasshi, 1984, 85(9):1001-1005.
[35]	台瑞, 方芳, 杨富, 等. 择期胃肠道手术患者预康复的最佳证据总结[J]. 中华护理杂志, 2024, 59(2):236-244. DOI URL
	Tai R, Fang F, Yang F, et al. Best evidence summary on prehabilitation interventions of patients undergoing elective gastrointestinal surgery[J]. Chin J Nurs, 2024, 59(2):236-244. DOI URL
[36]	刘华芳, 谢靓, 孙云. 术前营养风险评估结合早期肠内营养支持对食管癌患者术后康复的影响[J]. 中西医结合护理(中英文), 2024, 10(5):56-58.
	Liu HF, Xie L, Sun Y. Impact of preoperative nutritional risk assessment combined with early enteral nutrition support on postoperative recovery of esophageal cancer patients[J]. J Clin Nurs Pract, 2024, 10(5):56-58.
[37]	王佳燕, 鲜雪梅, 贺晓映, 等. 老年食管癌病人吞咽困难干预策略研究进展[J]. 护理研究, 2024, 38(8):1384-1388.
	Wang JY, Xian XM, He XY, et al. Progress of intervention strategies for dysphagia in elderly patients with esophageal cancer[J]. Chin Nurs Res, 2024, 38(8):1384-1388.
[38]	Takano Y, Kobayashi Y, Kudo T, et al. The role of geriatric nutritional risk index as a predictor for postoperative out-comes in gastrointestinal emergencies[J]. World J Surg, 2024, 48(1):40-47. DOI URL
[39]	姬雨行, 曹雄, 苏嘉诚, 等. 控制营养状态评分在预测机器人辅助食管癌根治术后并发症中的应用[J]. 机器人外科学杂志(中英文), 2025, 6(4):660-666.
	Ji YX, Cao X, Su JC, et al. Prognostic value of CONUT score in predicting postoperative complications following robot-assisted McKeown esophagectomy[J]. Chin J Rob Surg, 2025, 6(4):660-666.
[40]	朱心怡, 赵梅, 杨雅, 等. 临床护士营养护理能力量表的编制及信效度检验[J]. 中华护理杂志, 2021, 56(11):1672-1679. DOI URL
	Zhu XY, Zhao M, Yang Y, et al. The development and psy-chometric testing of nutritional care competence scale for clinical nurses[J]. Chin J Nurs, 2021, 56(11):1672-1679.
[41]	李海群, 朱心怡, 赵梅, 等. 安徽省4所综合医院临床护士营养护理能力现状及影响因素分析[J]. 中华护理杂志, 2022, 57(5):602-608. DOI URL
	Li HQ, Zhu XY, Zhao M, et al. The current situation and influencing factors of nutritional care competence for clinical nurses from 4 general hospitals in Anhui Province[J]. Chin J Nurs, 2022, 57(5):602-608. DOI URL