摘要
普外科围术期当中,具有中高营养风险的患者,其营养治疗率在长期以来一直处于偏低状态。传统的单科室管理模式,容易使患者术后出现并发症的风险升高,并且导致住院周期延长。围绕多学科协作在普外科围术期营养管理方面的应用,明确其在肝胆手术、胃肠道肿瘤根治术、急性胰腺炎等常见疾病场景里的应用价值,对当前实施过程中存在的障碍展开分析,并提出相应的优化策略。结果表明,多学科协作能够提高围术期中高营养风险患者的营养治疗覆盖率、干预规范性,改善患者的预后情况,可为普外科围术期营养管理模式的优化给予参考。
关键词: 围术期营养管理;多学科协作;普外科;营养风险
Abstract
During the perioperative period of general surgery, the nutritional therapy rate of patients with moderate and high nutritional risk has been in a low state for a long time. The traditional single-department management mode easily increases the risk of postoperative complications and prolongs the hospitalization period. Focusing on the application of multidisciplinary collaboration in perioperative nutrition management in general surgery, to clarify its application value in hepatobiliary surgery, radical resection of gastrointestinal tumors, acute pancreatitis and other common disease scenarios, analyze the obstacles in the current implementation process, and propose the corresponding optimization strategies. The results show that multidisciplinary collaboration can improve the coverage of nutritional treatment and the standardization of intervention for patients with moderate and high nutritional risk during the perioperative period, and improve the prognosis of patients. It can provide reference for the optimization of perioperative nutritional management mode in general surgery.
Key words: Perioperative nutrition management; Multidisciplinary collaboration; General surgery; Nutritional risk
参考文献 References
[1] 石洪瑞.加速康复外科理念在老年急性胆囊炎患者围手术期的循证医学研究[J].中国典型病例大全,2025,19(04): 667-671.
[2] Epidemiology, controversies, and dilemmas of perioperative nutritional risk/malnutrition: a narrative literature review[J]. Risk Management and Healthcare Policy, 2025, 18: 143-162.
[3] Keerio R, Ali M, Shah K A, et al. Evaluating the impact of preoperative nutritional status on surgical outcomes and public health implications in general surgery patients[J]. Cureus, 2024, 16(12): e76633.
[4] 于福文,王辰茜,田书霞. 腹部外科手术患者营养风险和营养支持治疗情况调查[J]. 中国中西医结合外科杂志,2024,30(1):100-104.
[5] 郝冉,韩艳艳.心脏外科围术期病人营养支持的研究进展[J].全科护理,2026,24(01):48-51.
[6] 李子建,陈伟. 以加速康复外科为契机优化围手术期营养管理[J]. 中华外科杂志,2019,57(7):513-516.
[7] 夏伊达·肖开提.MDT模式下的营养干预在老年消化系统疾病患者围术期的应用[D].新疆医科大学,2023.
[8] 吕季阳,李红,韩贺,等.加速康复外科围术期营养管理对胃切除术后肠黏膜屏障的影响[J].江苏大学学报(医学版),2020,30(06):531-536.
[9] 刁齐翔,罗玉玲,王守碧,等.减重代谢术后患者饮食及营养管理的最佳证据总结[J].护理实践与研究,2026,23(01):31-38.
[10] 各级医院临床营养科建设现状调查分析[J].海南医学.
[11] 健康中国看山西:省人民医院营养科开展适宜性技术下基层推广县级人才培养项目系列活动[EB/OL].2025.
[12] 图尔荪阿依·图尔荪.MDT模式下营养干预促进骨折老年围术期康复和改善预后的效果研究[D].新疆医科大学,2020.
[13] 邢健为,陈求赞,赵丽娟,等.多学科团队诊疗模式在肝胆外科中的应用现状[J].中国临床医生杂志,2026,54(03):305-309.
[14] 陈琴,倪俏.基于中医整体观的快速康复外科理念在肝胆外科围术期管理中的应用[J].中医药管理杂志,2025, 33(23):75-77.
[15] 中国康复医学会社区康复工作委员会,贾杰. 基于加速康复外科理念的肝癌围术期营养管理专家共识(2025版)[J]. 中国全科医学,2026,29(8):953-964.
[16] 卞晔,李福宁,孙甜甜. 基于MDT营养管理模式在胃癌患者围术期营养管理中的应用效果[J]. 吉林医学,2025, 46(9):2261-2266.
[17] 秦艳红,李丽萍,马艳艳. 基于多学科团队的个体化营养干预应用于结肠癌术后患者的效果[J]. 黔南民族医专学报,2025,38(1):85-87.
[18] Effectiveness of nutrition support team-led care on perioperative outcomes in malnourished older adults with gastric cancer[J]. Frontiers in Nutrition, 2025, 12: 1707892.
[19] 张川林,牟绍玉,张慧. 有营养风险患者的营养支持效果与卫生经济学评价[J]. 中国老年学杂志,2016,36(18): 4594-4596.
[20] 林芝,陈晓青,王婷婷.神经重症患者肠内营养支持的治疗效果研究[J/OL].重庆医学,1-8[2026-04-10].
[21] 朱锦锦,钱欢.多学科协作模式在神经外科重症合并肋骨骨折患者呼吸道管理中的实践与效果评价[J/OL].中国典型病例大全,1-6[2026-04-10].