Application of standardized nutrition therapy and nursing in patients with colorectal cancer / 中国实用护理杂志

Objective:To explore the effect of standardized nutrition therapy and nursing in patients with colorectal cancer.Methods:From June 2017 to June 2019, 70 patients with colorectal cancer were selected. They were divided into control group ( n=35) and observation group ( n=35) by random digital table method. The control group was given routine nutrition treatment and nursing, while the observation group was given standardized nutrition treatment plan and nursing. The clinical indexes, nutritional indexes and complications of the two groups were compared, and the immune function before and after operation was compared. Results:The recovery time of bowel sounds, anal exhaust time, defecation time and hospitalization time in the observation group were (3.62±0.64) h, (36.78±11.25) h, (69.74±20.12) h, (15.81±3.57) h, respectively. The control group were (4.08±0.92) h, (44.96±13.83) h, (92.76±19.86) h, (18.83±4.56) h, the difference was statistically significant ( t values were 2.43-4.82, P<0.05 or 0.01). After 7d, the body mass, prealbumin, hemoglobin and serum albumin in observation group were (52.13±5.17) kg, (197.63±39.72) mg/L, (109.74±11.25) g/L, (41.85±5.67) g/L, respectively. The control group were (49.34±4.82) kg, (168.73±32.47) mg/L, (104.06±7.93) g/L, (37.92±4.53), respectively. The difference was statistically significant ( t values were 2.34-3.33, P<0.05 or 0.01). The IgA, IgG, IgM, CD4, CD4/CD8 in the observation group (1.93±0.54) g/L, (11.47±2.35) g/L, (0.96±0.21) g/L, (40.32±5.22)%, 1.68±0.38, the control group were (1.65±0.35) g/L, (9.81±1.69) g/L, (0.81±0.17) g/L, (37.81±4.45)%, 1.49±0.33,The difference was statistically significant ( t values were 2.16-3.39, P<0.05 or 0.01). Conclusions:Standardized nutrition treatment process and nursing can improve the prognosis of colorectal cancer patients, promote the recovery of gastrointestinal function, improve the nutritional status of the body, enhance the immune function of the body.

Strategy of enhanced recovery in intensive care / 医学研究生学报

With the rapid development of critical care medicine, more and more patients can survive from the initial severe stress and though the acute period of the disease, but fail to recover completely and consequently develop chronic critical disease, leading to extended hospital stay in the ICU. To resolve this urgent problem in critical care medicine, we present an overview of the commonly accepted concepts of enhanced recovery in the ICU, focusing on early mobilization, phased strategy of nutrition treatment, appropriate analgesia and sedation, promotion of sleep recovery in the ICU, and protocolized family support intervention, so as to reduce various avoidable stresses and promote the recovery of the patient in the ICU.

The application of processized nutrition treatment strategy in critically ill patients / 中国中西医结合急救杂志

Objective To explore the effect of processized nutrition treatment strategy on the clinical efficacy of critically ill patients.Methods A prospective study was conducted, and 195 patients admitted to Department of Intensive Care Unit of Jiaxing Second Hospital from July 2016 to February 2017 were enrolled. From July to September 2016, 94 cases were assigned in the control group, and they were given the routine nutritional treatment program. From October to November 2016, the training of processized nutrition treatment strategy was carried out and improved according to plan-do-check-act (PDCA) cycle management plan, From December 2016 to February 2017, 101 cases were assigned in the observation group and treated by the doctor and nurse processized nutrition treatment strategy. The differences of early enteral nutrition (EEN) ratio, the time reaching standard of enteral nutrition (EN) in two group were compared, the incidence of complications related to EN, mechanical ventilation time, ICU hospitalization time, ICU expense and mortality were observed between the two groups.Results Compared with the control group, the ratio of EEN was significantly increasedin the observation group [90.1% (91/101) vs. 47.9% (45/94)], the time reaching standard of EN shortened (days: 5.18±1.43 vs. 6.47±1.95), the incidences of gastrointestinal tract related complications [0.77% (9/1173) vs. 1.67% (22/1319)] and ventilator associated pneumonia [VAP: 4.90‰(4/816) vs. 15.32‰(16/1044)] were obviously decreased, ICU hospitalization time (days:11.61±5.93 vs. 14.03±8.27), mechanical ventilation time (days: 8.08±6.16 vs. 11.11±7.87), the mortality [23.76% (24/101) vs. 31.91% (30/94)] were significantly reduced in the observation group (allP < 0.05), but the ICU hospitalization expenses had no significant difference in observation group and control group (millions: 7.26±7.23 vs. 7.07±4.60,P > 0.05).Conclusions The processized nutrition treatment strategy can improve the EEN implementation rate of critically ill patients, help to establish EN as early as possible, reduce the incidence of gastrointestinal and pulmonary infections and other complications.

Tratamento nutricional da anorexia e da bulimia nervosas: aspectos psicológicos dos pacientes, de suas famílias e das nutricionistas / Nutritional treatment of the anorexia and bulimia: the psychological aspects of the patient, of their families and of the dietitians / Tratamiento nutricional de la anorexia y la bulimia: los aspectos psicológicos de los pacientes, sus familias y nutricionistas

Este estudo tem como objetivo descrever o tratamento nutricional dos transtornos alimentares (TAs), os aspectos psicológicos relacionados aos pacientes e aos seus familiares e os impactos psicológicos acarretados aos nutricionistas que atuam no tratamento destes transtornos. A abordagem foi qualitativa, em que foram realizadas entrevistas semi-estruturadas, áudio-gravadas, com quatro nutricionistas que trabalham junto a pacientes com TAs em instituições vinculadas a universidades e em clínicas particulares. Foi observado que, apesar dos pacientes com TA serem englobados em características comuns destas doenças, cada um deles deve ser entendido como um caso individualizado, uma vez que a motivação para o controle sobre o corpo e sobre a alimentação é única para cada pessoa. Foi observado também que o tratar de TA acarreta um impacto psicológico no nutricionista, o qual precisa ser trabalhado através de uma reflexão sobre os próprios sentimentos, podendo isto ser realizado com apoio terapêutico.

This study aims to describe the nutritional treatment of the eating disorders (ED), the psychological aspects related to the patients and their families and the psychological impacts entailed to the dietitians who act with patients with these disorders. The research had a qualitative approach, in which semi-structured and audio-recorded interviews were done with four dietitians who act with ED at institutions linked to universities and at private clinics. It was observed that, although patients with ED are grouped with common characteristics for these diseases, each of them should be understood as an individual case, since the motivation for the body and eating control is unique for each person. It was also observed that the treatment of ED entails a psychological impact on the dietitian, which needs to be worked through with a reflection about his own feelings, what can be performed with therapist support.

El objetivo de este estudio es describir el tratamiento nutricional de los trastornos alimentarios (TA), los aspectos psicológicos relacionados con los pacientes y sus familias y los impactos psicológicos que producen en los nutricionistas que actúan tratando estas enfermedades. La investigación se hizo con un abordaje cualitativo, por medio de entrevistas semiestructuradas, con grabación de audio, conducidas por cuatro nutricionistas que actúan con pacientes que sufren trastornos alimentarios (TA) en instituciones vinculadas a universidades y en clínicas particulares. Se observó que, aunque los pacientes con TA tienen características comunes de estas enfermedades, cada uno de ellos debe considerarse como un caso particular, ya que las motivaciones de cada persona para controlar el propio cuerpo y la alimentación son únicas. También se observó que tratar los TA produce un impacto psicológico en el nutricionista, que debe trabajarse reflexionando sobre los propios sentimientos, cosa que puede hacerse con apoyo terapéutico.

The therapeutic of nutrition support with somatostatin in patients with gastro-esophagus leakage after proximal gastrectomy for gastric cancer / 中国基层医药

Objective To study the effect of nutrition support with somatostatin in patients with gastro- esophagus leakage after proximal gastrectomy. Methods 6 patients with gastro-esophagus leakage after proximal gastrectomy for gastric cancer from July 2004 to September 2009 were enrolled. Then, the patients were treated with improved drainage, parenteral & enteral nutrition and somatostatin. Furthermore, nutrition index and duration of recovery were investigated respectively. All data were analyzed between preoperative and postoperative by student's T-Test.Results 6 patients were cured after non-operation. The average period of in-hospital was 32 days. Compared with the post-leakage day 1 ,the nutrition states were significantly improved when patients recovered( P ＜0. 01 ). Non-complication happened. Conclusion It was an effective way to improve the nutrition state and to promote the gastro-esophagus leakage healing.

Resting energy expenditure in patients with well controlled type 2 diabetes mellitus / 中华临床营养杂志

Objective To investigate the features of resting energy expenditure (REE) in patients with well controlled type 2 diabetes mellitus (T2DM). Methods Totally 45 T2DM patients with stable blood glucose were enrolled. The general conditions, biochemical indicators, measurements of REE ( MREE), and basal energy expenditure (BEE) calculated with Harris-Benedict formula (HBEE) and Owen formula (OBEE) were recorded and compared. Results MREE had no significant difference with HBEE or OBEE in T2DM patients with stable blood glucose (P ＞ 0. 05). Correlation analysis showed that REE was significantly correlated with gender, age, body weight, body height, body surface area, and fat-free mass ( all P ＜ 0.05 ), but was not correlated with body mass index, fat mass, fasting plasma glucose, postprandial plasma glucose, haemoglobin Alc, total cholesterol, triglyceride, total protein, albumin, and haemoglobin (P ＞ 0. 05 ). Multiple regression analysis showed that fat free mass and age had the closest correlation with REE. Conclusions REE does not increase in T2DM patients with well controlled blood glucose. Factors that influence their REE are similar with healthy individuals. Determi nation of REE can provide useful information for the nutrition treatment of T2DM.

Effect of micronutrients on pressure ulcer / 肠外与肠内营养

The effect of micronutrients on pressure ulcer was reviewed.Nutritional treatment is helpful to prevent and cure the pressure ulcer.Especially micronutrients should be paid more attention to.

The recovery effect of early enteral nutrition in elderly patients with severe chest trauma / 肠外与肠内营养

Objective:To evaluate the recovery effect of early enteral nutrition (EEN) in elderly patients with severe chest trauma.Methods:83 elderly patients with severe chest trauma were divided randomly into two groups,research group(46 patients) and control group(37 patients).In both groups the nutrition indicator,the complication and the recovery time were detected on admission (T1),the 1st week (T2) and 2ed week (T3) after admission.Results:After 2 weeks,the level of nutrition indicator in research group was significantly higher than in control group,and the incidence of complication was significantly lower than in control group.Conclusion:Early enteral nutritional support is helpful for the nutritional support and reduce the support of complication in elderly patients with severe chest trauma.